The coronary or coronary artery is an artery or vein that supplies the heart muscle with blood or removes it from it. The coronary vessels are arranged in a ring around the heart . The word comes from the Latin coronarius , which means crown or wreath-shaped.
The coronary arteries ( Arteriae coronariae ) arise from an indentation in the aorta just above the aortic valve in the valve plane. There is a left ( arteria coronaria sinistra ) and a right coronary artery ( arteria coronaria dextra ). They are named with left-right after the half of the heart that is supplied.
The left coronary artery (LCA) divides about 1 cm into the circumflex branch (RCX) and the anterior interventricular ramus (RIVA, left anterior descending , LAD), which runs between the left and right ventricle to the apex. Up to the fork, one speaks of the main trunk ( Truncus communis ). Sometimes the main stem also divides into three vessels, the middle one is then called Ramus intermedius (RIM); it extends over the free wall of the left ventricle to the apex of the heart. The left artery supplies the anterior cardiac wall, the side wall, the posterior wall and the septum (wall between the main chambers).
The right coronary artery (RCA) has a main branch, the ramus interventricularis posterior (RIVP, English: posterior descendent artery , PDA). The posterior wall and the sinus and AV nodes are usually supplied by the right coronary artery, as are the right ventricle and the right atrium and, in some cases, also the left ventricle.
Both coronary arteries ( Arteriae coronariae ) also give off smaller branches in their course, which, however, are often subject to variations depending on the type of supply. The anatomical names are listed below, the clinically used names are given in brackets; the supply areas, the relevant ones, because the vessels are usually strong, are in italics.
Branches from the Ramus circumflexus (RCX):
- Ramus marginalis sinister ( Ramus marginalis , lateral wall / side wall)
- Atrial branch
- Rami posteriores ventriculi sinistri ( Ramus posterolateralis sinister , posterolateral wall / posterior wall)
Branches from the Ramus interventricularis anterior (RIVA, Syn: left anterior descending coronary artery LAD, anterior wall to the apex of the heart):
- Rami laterales ( Ramus diagonalis , anterolateral wall)
- Rami interventriculares septales (septal branches, parts of the septum)
Branches from the dextra coronary artery (RCA):
- Ramus nodi sinuatrialis (sinus node artery)
- Ramus coni arteriosi
- Atrial branch
- Ramus marginalis dexter
- Ramus nodi atrioventricularis (AV nodal artery)
- Division (bifurcation) of the RCA in the area of the " crux cordis " in
When the left coronary artery jointly supplied and the rear wall and the nodes it is called a left provider type , at a (co-) supply of the front wall through the right coronary artery from a legal provider type ; the normal case is called the intermediary type.
The normal case (around 80% of the population) is the balanced type .
The left coronary artery (left coronary artery) supplies:
- the left atrium,
- the muscles of the left ventricle,
- most of the interventricular septum,
- a portion of the anterior wall of the right ventricle.
The dextra coronary artery (right coronary artery) supplies:
- the right atrium,
- the muscles of the right ventricle,
- the posterior part of the interventricular septum,
- the sinus node,
- the AV node,
- a portion of the posterior wall of the left ventricle.
Coronary heart disease
The coronary arteries are terminal arteries , there are no bypass circuits that could supply the same area in an emergency. In the event of an obstruction, the muscle area that is not supplied with it dies ( heart or myocardial infarction ). If the coronary arteries are damaged, one speaks of coronary heart disease (CHD). Heart attack is a persistent circulatory disorder (ischemia) of parts of the heart muscle (myocardium), which in most cases is caused by blood clots in a narrow point in a coronary artery. One speaks of an arteriosclerotically changed narrowing of the vessel.
The large coronary veins ( Venae cordis ) run parallel to the coronary arteries for long stretches and open into the right atrium via the transverse coronary sinus . Smaller coronary veins open directly into the right atrium or into other heart spaces, such as the Vv. Ventriculi dextri (right ventricle) and the Vv. Cardiacae minimae or Thebesius veins (inner spaces of the heart).
The great coronary veins ( Venae cordis ) are:
- Vena cordis magna
- Vena cordis media
- Vena cordis parva
- Atherosclerosis (arteriosclerosis)
- Helmut Roskamm , F.-J. Neumann, u. a. (Ed.): Heart Diseases. Pathophysiology Diagnostics Therapy. 5th edition. Springer, Berlin a. a. 2004, ISBN 3-642-18649-1 . (Table of contents of the 76 chapters)
- Introduction - Coronary Vessels and Myocardial Infarction (accessed February 15, 2016)
- Detection, quantification and morphological characterization of atherosclerotic lesions of the coronary vessels (accessed on February 15, 2016)
- The different blood supply to the heart muscle (accessed on February 15, 2016)