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Coronary Anatomy: A Basic Guide

The heart has its own set of blood vessels called the coronary arteries to supply its oxygen and nutrient requirements. Mastery of coronary anatomy is essential for healthcare professionals dealing with various cardiovascular emergencies and is the best preparation to learn ECG interpretation.

The blood supply to the myocardium branches out from the aorta in the following manner. The aortic valve has three cusps: the left coronary cusp, which gives rise to the left coronary artery; the right coronary cusp, which gives rise to the right coronary artery; and the posterior non-coronary cusp, which usually does not give rise to a coronary artery. In most cases, the left coronary artery bifurcates into two branches, namely: the left anterior descending artery (LAD) and the ramus circumflexus (RCx), also known as the left circumflex artery (LCx). Occasionally, a third branch called ramus intermedius (Int) may arise between the LAD and the RCx.

The LAD courses over the anterior aspect of the heart through the anterior interventricular sulcus (AIVS), an anterior groove in between the right and left ventricles. It gives off several branches called diagonal branches that course diagonally on the anterolateral portion of the left ventricle.

The right coronary artery (RCA) arises from the aorta above the right cusp of the aortic valve. It then courses through the right atrioventricular sulcus, a groove between the right atrium and right ventricle. The RCA gives off several branches including: the SA-nodal artery; acute marginal (AM) branch, also known as the right marginal artery or the RV-branch; RDP; RPLA which gives off one or more PL branches to the left ventricle; and AV-nodal artery.

This basic guide to coronary anatomy, complete with an interactive anatomic illustration, is just one of the many examples of learning tools found in CardioCollege.com. In addition, the website contains several comprehensive and step-by-step review courses on cardiac anatomy, physiology, and the ECG.

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