The Coronary Arteries

  1. Home
  2. »
  3. Anatomy
  4. »
  5. The Coronary Arteries

The heart is a muscular pump about the size of a fist.

Located at the center of the thorax, between the 2 lungs, the heart is the engine of the circulatory system. Normal heart function is closely linked to oxygenation.

The Coronary Arteries

Its precious fuel is delivered to the heart by the coronary arteries. Any reduction in oxygen supply can have serious and sometimes irreversible effects on the heart.

Let’s take a closer look at the coronary arteries.

The Left and Right Coronary Arteries

These 2 coronary arteries are located directly on the surface of the heart. They branch out through the entire cardiac muscle.

The coronary arteries are the first to leave the aorta, the largest artery in the body. Their starting point is found immediately above the aortic valve.

Denomination of the Coronary Artery Branches

Patients, who have the privilege of benefitting from one or more coronary artery repair interventions with the installation of one or more tiny metal mesh tubes called stents, are often curious to know the name of that or those arteries. Following, are a few details on the anatomy of the coronary arteries.

The left coronary artery divides into 2 parts almost immediately after leaving the aorta. This first segment is named the left main.

The first part, called the Left Anterior Descending, goes down the front portion of the heart. It runs along the anterior interventricular groove, i.e. the attachment junction between the 2 ventricles at the front of the heart. The branches that break away from this artery are named diagonal arteries.

The second part, the circumflex artery, arises from the common trunk and bypasses the heart to the left. The branches that split off from this artery are called marginal arteries.

The right coronary artery passes around the heart on the right and, in 9 out of 10 people, descends at the back of the heart towards its lower end. It runs along the posterior attachment junction of the right ventricle to the left ventricle. This portion of the artery is called the posterior interventricular artery. In 1 case out of 10, the posterior interventricular artery is a branch of the circumflex coronary artery located on the left side of the heart.

Ample needs fulfilled

Notwithstanding the preceding, the heart’s oxygen requirements are met effectively and sufficiently. The human body is designed to adequately oxygenate this motor in charge of circulating oxygen and vital nutrients throughout the rest of the body.

Even a third of the time it takes for red blood cells to pass through the capillaries would suffice to deliver enough oxygen to the cardiac muscle. The capillaries are the microscopic vessels where red blood cells pass through in a single file to release oxygen into the muscle and take away the carbon dioxide generated by the heart’s work.

Everything works perfectly well as long as the need for oxygen is in harmony with its supply.

The 4 “fuel” Consumption Factors

Let’s take a look at the 4 elements that determine the heart’s oxygen (02) requirements. We could compare them to those that are used to establish a car’s fuel consumption.

Consider the following:

  • the state of the air filter. Ideally, it is thoroughly clean;
  • the car’s aerodynamics;
  • the power of the engine;
  • the speed of the car.

 

In the heart, oxygen needs are determined by:

  • the adequate filling of the left ventricle. It should be neither too empty nor too full;
  • the left ventricle’s resistance to emptying its contents into the aorta;
  • the force of its contractions;
  • the heart rate.

Heart Medicines Act on These Factors

In the case of certain illnesses, such as angina, the doctor prescribes medication to reduce the heart’s workload and oxygen (O2) requirements.

The medication exerts a sensitive effect on one or more factors of oxygen consumption.

An Oxygen Carrier Is Required

Oxygen supply depends on the number of red blood cells in the blood. These are the “little boats” responsible for transporting oxygen in the blood.

Hémoglobine

Reliable Pipes Are Essential

The oxygen supply also depends on the state of the piping that irrigates the heart, i.e., the coronary arteries.

Those Pipes Are Made Up of 3 Layers

The coronary arteries, like all the other arteries in the human body, are made up of 3 layers.

Each plays a specific role, but the central layer is particularly important in the development of cholesterol plaques.

Internal layer: intima

The internal layer, the intima, is like a thin coating of Teflon. It is responsible for the integrity of the vessel and protects it from the formation of blood clots.

The intima naturally releases substances used to lubricate and dilate the vessel when necessary, preventing harmful matters from adhering to its wall.

One of the secreted substances can be compared to nitroglycerin which some patients use to soothe chest pain caused by angina. The intima thus helps to keep the vessel well enlarged, in case of need.

Middle layer: media

The media, in the center, is thicker and made up of smooth muscle cells. It gives the artery the ability to spasm or dilate.

The nitroglycerin some people use for angina acts on this layer. It induces vessel relaxation. The vessel becomes larger, circulation improves and angina is relieved.

The media layer is also where cholesterol plaques settle, giving arteries a yellowish appearance, as seen from the outside.

External layer: adventitia

The adventitia is the external coating. It is the most resistant part of the artery and offers a protective effect to the vessel.