🫀 _Coronary_Artery

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🫀 Coronary Artery Anatomy
Introduction
The coronary arteries are vital blood vessels that supply oxygenated blood to the heart muscle (myocardium). Since the heart continuously pumps blood throughout the body, it requires a constant and rich oxygen supply to function effectively. Any obstruction in these arteries can lead to serious cardiac conditions such as angina or myocardial infarction (heart attack).

Origin
The coronary arteries arise from the ascending aorta, just above the aortic valve, from two openings called the coronary ostia. There are two main coronary arteries:


Right Coronary Artery (RCA)
Left Coronary Artery (LCA)


1. Right Coronary Artery (RCA)
The RCA originates from the right aortic sinus and travels in the right atrioventricular (AV) groove between the right atrium and right ventricle.


Major Branches of RCA:
Conus branch – supplies the right ventricle outflow tract.
Right marginal branch – supplies the right ventricular wall.
Posterior descending artery (PDA) – supplies the posterior part of the interventricular septum and adjacent ventricles.


Atrioventricular nodal branch – supplies the AV node.
Areas Supplied:
Right atrium
Most of right ventricle
Posterior part of left ventricle
SA node and AV node (in most individuals)


2. Left Coronary Artery (LCA)
The LCA arises from the left aortic sinus and passes between the pulmonary trunk and left atrial appendage before dividing into two main branches.


Main Branches:
Left Anterior Descending (LAD) artery / Anterior interventricular artery
Runs in the anterior interventricular groove.
Supplies anterior wall of left ventricle, anterior two-thirds of interventricular septum, and apex of the heart.


Left Circumflex (LCX) artery
Runs in the left atrioventricular groove.
Supplies the left atrium and lateral and posterior walls of the left ventricle.

Coronary Dominance
Dominance refers to which coronary artery gives rise to the Posterior Descending Artery (PDA):
Right dominant – PDA arises from RCA (≈ 85% of people)
Left dominant – PDA arises from LCX (≈ 8–10%)
Co-dominant – both contribute (≈ 5%)


Venous Drainage
The venous blood from the myocardium is mainly collected by the coronary sinus, which drains into the right atrium. Minor veins include the anterior cardiac veins and Thebesian veins.


Clinical Significance
Coronary artery disease (CAD): Atherosclerotic plaque formation causes narrowing of the arteries, reducing blood flow.

Myocardial infarction (heart attack): Complete blockage leading to tissue death.
Coronary angiography: Diagnostic imaging to visualize coronary anatomy.


Bypass grafting or angioplasty: Treatments to restore blood flow.


Conclusion
The coronary arteries are the heart’s life-support system, ensuring continuous delivery of oxygen and nutrients to cardiac muscle. Understanding their anatomy is essential for diagnosing and managing cardiovascular diseases effectively.

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