CORONARY
CIRCULATION
Dr. MAHVISH QAISER (PT)

CORONARY CIRCULATION
 Coronary circulation is the circulation of blood in the blood vessels of the
heart.
 Coronary circulation consists:
 Arterial supply
 Venous supply
I. Arterial supply:
Heart is supplied by two coronary arteries arising from the ascending aorta.
Both arteries run in the coronary sulcus.
Two arteries are:
 The right coronary artery
 The left coronary artery

A. Right coronary artery:
 Smaller than the left coronary artery.
 Arises from the ascending aortic sulcus.
COURSE:
 It first passes forwards and to the right to emerge on the surface of the heart
between the roots of the pulmonary trunk and right auricle.
 It then runs downwards in the right anterior coronary sulcus to the junction of the
right and inferior borders of the heart.
 It winds around the inferior borders to reach the diaphragmtic surfae of the heart.
Here it runs backwards & to the left in the right posterior coronary sulcus to reach
the posterior interventricular groove.

It terminates by anastomosing with left coronary artery.
BRANCHES:
Large branches: Marginal
Posterior interventricular
Small branches: Nodal in 60% cases
Right atrial
Infundibular
Terminal
AREAS OF DISTRIBUTION:
1. Right atrium
2. Ventricles
 Greater part of right ventricles except the area adjoining the anterior
interventricular groove.
 A small part of left ventricle adjoining the posterior interventricular groove.

3. Posterior part of interventricular septum
4. whole of the conducting system of the heart except a part of the left branch of the
AV bundle.
B. Left coronary artery
Larger than the right coronary artery.
Arises from the left posterior aortic sinus.
COURSE:
The artery runs forward and to the left & emerges between the pulmonary trunk
and the left auricle.
Here the anterior interventricular branch is given.
The futher continuation of the left coronary arteryis sometimes called circumflex
artery.
After giving off the anterior interventricular branch it runs into the left anterior
coronary sulcus.

 It winds around the left border and near posterior interventricular grooveit terminates by anastomozing with th
right coronary artery.
BRANCHES:
Large branches: Anterior interventricular
branches to the diphragmatic
surface of the left ventricle.
Small branches: Left atrial
Pulmonary
Terminal
AREAS OF DISTRIBUTION:
1. Left atrium
2. Ventricles
 Greater part of left ventricles except the area adjoining the posterior interventricular groove.
 A small part of right ventricle adjoining the anterior interventricular groove.
3. Anterior part of interventricular septum
4. A part of the left branch of the AV bundle.

II. Venous supply: The venous drainage of the heart is by three means.
Coronary sinus
Anterior cardiac vein
Vein cordis minimas
A. Coronary sinus:
This is the largest vein of heart
situated in the left posterior coronary
sulcus.
Its tributaries are:
Great cardiac vein- It enters the left end of the coronary sinus.
Middle cardiac vein- It acccompanies posterior interventricular artery & joins
right end of the coronary sinus.

Small cardiac vein- It accompanies right coronary artery & joins right end of the
coronary sinus.
 Posterior vein of left Ventricle- It runs on the diphragmatic surface of the left
ventricle & ends in the middle of the coronary sinus.
Oblique vein of left atrium-a small vein running on the posterior surface of the
left atrium.
Right marginal vein- It accompanies the marginal branch of right coronary
artery.

B. Anterior cardiac vein:
3 or 4 veins run on the anterior wall of the right ventricle, open directly into the
right artrium.
C. Venae cordis minimi:
Also known as Thebesian vein and smallest cardiac vein
Numerous small veins present in all four chambers of the heart which opens
directly into the cavaties. Thsese are more numerous on the right side of the
heart than on the left.

CLINICALASPECTS:
1. Thrombosis of the coronary artery:
This is due to themyocardial infarction and ventricular fibrillation.
2. Angina Pectoris:
Incomplete obstruction, usually due to the spasm of coronary artery
causes angina pectoris.
3. Coronary angioplasty:
It determines the site(s) of narrowing occlusion of coronary arteries.
4. Angioplasty:
It helps in removal of small block by using small inflated ballon.

THANKYOU