Sinoatrial nodal artery

Last updated
Sinoatrial nodal artery
Sinoatrial node 2 low mag.jpg
Low magnification micrograph of a sinoatrial node (central on image), surrounding the sinuatrial nodal artery (on lumen in the image). H&E stain.
Cardiac vessels.png
Details
Identifiers
Latin ramus nodi sinuatrialis arteriae coronariae dextrae
TA98 A12.2.03.104
A12.2.03.212
TA2 4133
FMA 3823
Anatomical terminology

The sinoatrial nodal artery, sinuatrial nodal artery or sinoatrial artery is an artery of the heart which supplies the sinoatrial node, the natural pacemaker center of the heart. It is usually a branch of the right coronary artery. [1] It passes between the right atrium, and the opening of the superior vena cava. [2]

Contents

Anatomy

Origin

It arises from the right coronary artery in around 60% of individuals, from the left circumflex coronary artery in about 40% of individuals, [1] and in less than 1% of humans, the artery has an anomalous origin directly from the coronary sinus, descending aorta, or distal right coronary artery.[ citation needed ]

The origin of the sinoatrial node artery is not related to coronary artery dominance, which means the side (right or left) that provides the circulation to the back of the heart. In contrast, the atrioventricular nodal branch, that is the artery that brings blood to the atrioventricular node, depends on coronary artery dominance.[ citation needed ]

Course

In more than 50% of human hearts, the artery actually courses close to the superior posterior aspect of the interatrial septum. [3]

The sinoatrial node surrounds the sinoatrial artery, which can run centrally (in 70% of individuals) or off-center within the node. [4]

Variation

A left S-shaped sinoatrial artery, originating from the proximal left circumflex or LCx artery, has been described as a common variant in approximately 10% of human hearts. [5] This artery is larger than normal and supplies a good part of the left atrium, but also right-sided structures like part of the sinoatrial node and the atrioventricular nodal areas. In this variant, the artery courses in the sulcus between the left superior pulmonary vein and the left atrial appendage where it could be susceptible to injury during catheter or surgical ablation procedures on the left atrium, especially for atrial fibrillation ablation or open-heart cardiac surgery.[ citation needed ]

Additional images

Related Research Articles

<span class="mw-page-title-main">Heart</span> Organ found inside most animals

The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest, called the mediastinum.

<span class="mw-page-title-main">Coronary circulation</span> Circulation of blood in the blood vessels of the heart muscle (myocardium)

Coronary circulation is the circulation of blood in the arteries and veins that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle. Cardiac veins then drain away the blood after it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment. Interruptions of coronary circulation quickly cause heart attacks, in which the heart muscle is damaged by oxygen starvation. Such interruptions are usually caused by coronary ischemia linked to coronary artery disease, and sometimes to embolism from other causes like obstruction in blood flow through vessels.

<span class="mw-page-title-main">Systole</span> Part of the cardiac cycle when a heart chamber contracts

Systole is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood.

<span class="mw-page-title-main">Sinoatrial node</span> Group of cells located in the wall of the right atrium of the heart

The sinoatrial node is an oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of cells known as pacemaker cells. The sinus node is approximately 15 mm long, 3 mm wide, and 1 mm thick, located directly below and to the side of the superior vena cava.

<span class="mw-page-title-main">Atrioventricular node</span> Part of the electrical conduction system of the heart

The atrioventricular node or AV node electrically connects the heart's atria and ventricles to coordinate beating in the top of the heart; it is part of the electrical conduction system of the heart. The AV node lies at the lower back section of the interatrial septum near the opening of the coronary sinus, and conducts the normal electrical impulse from the atria to the ventricles. The AV node is quite compact.

<span class="mw-page-title-main">AV nodal reentrant tachycardia</span> Medical condition

AV-nodal reentrant tachycardia (AVNRT) is a type of abnormal fast heart rhythm. It is a type of supraventricular tachycardia (SVT), meaning that it originates from a location within the heart above the bundle of His. AV nodal reentrant tachycardia is the most common regular supraventricular tachycardia. It is more common in women than men. The main symptom is palpitations. Treatment may be with specific physical maneuvers, medications, or, rarely, synchronized cardioversion. Frequent attacks may require radiofrequency ablation, in which the abnormally conducting tissue in the heart is destroyed.

<span class="mw-page-title-main">Atrium (heart)</span> Part of the human heart

The atrium is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.

<span class="mw-page-title-main">Cardiac cycle</span> Performance of the human heart

The cardiac cycle is the performance of the human heart from the beginning of one heartbeat to the beginning of the next. It consists of two periods: one during which the heart muscle relaxes and refills with blood, called diastole, following a period of robust contraction and pumping of blood, called systole. After emptying, the heart relaxes and expands to receive another influx of blood returning from the lungs and other systems of the body, before again contracting to pump blood to the lungs and those systems. A normally performing heart must be fully expanded before it can efficiently pump again. Assuming a healthy heart and a typical rate of 70 to 75 beats per minute, each cardiac cycle, or heartbeat, takes about 0.8 second to complete the cycle.

<span class="mw-page-title-main">Right coronary artery</span> Blood vessel supplying the human heart

In the blood supply of the heart, the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus in the heart. It travels down the right coronary sulcus, towards the crux of the heart. It gives off many branches, including the sinoatrial nodal artery, right marginal artery, posterior interventricular artery, conus artery, and atrioventricular nodal branch. It contributes the right side of the heart, and parts of the interventricular septum.

<span class="mw-page-title-main">Coronary sinus</span> Set of veins which drain blood from the myocardium (heart muscle)

The coronary sinus is the largest vein of the heart. It drains over half of the deoxygenated blood from the heart muscle into the right atrium. It begins on the backside of the heart, in between the left atrium, and left ventricle; it begins at the junction of the great cardiac vein, and oblique vein of the left atrium. It receives multiple tributaries. It passes across the backside of the heart along a groove between left atrium and left ventricle, then drains into the right atrium at the orifice of the coronary sinus.

<span class="mw-page-title-main">Bachmann's bundle</span> Anatomical cardiac structure

In the heart's conduction system, Bachmann's bundle is a branch of the anterior internodal tract that resides on the inner wall of the left atrium. It is a broad band of cardiac muscle that passes from the right atrium, between the superior vena cava and the ascending aorta. Bachmann's bundle is, during normal sinus rhythm, the preferential path for electrical activation of the left atrium. It is therefore considered to be part of the "atrial conduction system" of the heart.

<span class="mw-page-title-main">Coronary sulcus</span> Groove on the surface of the heart that separates the atria from the ventricles

The coronary sulcus is a groove on the surface of the heart at the base of right auricle that separates the atria from the ventricles. The structure contains the trunks of the nutrient vessels of the heart, and is deficient in front, where it is crossed by the root of the pulmonary trunk. On the posterior surface of the heart, the coronary sulcus contains the coronary sinus. The right coronary artery, circumflex branch of left coronary artery, and small cardiac vein all travel along parts of the coronary sulcus.

<span class="mw-page-title-main">Circumflex branch of left coronary artery</span> Artery of heart

The circumflex branch of left coronary artery is a branch of the left coronary artery. It winds around the left side of the heart along the atrioventricular groove. It supplies the posterolateral portion of the left ventricle.

<span class="mw-page-title-main">Atrioventricular nodal branch</span>

The atrioventricular nodal branch is a coronary artery that supplies arterial blood to the atrioventricular node, which is responsible for initiating muscular contraction of the ventricles. The AV nodal branch is most often a branch of the right coronary artery.

<span class="mw-page-title-main">Junctional ectopic tachycardia</span> Medical condition

Junctional ectopic tachycardia (JET) is a rare syndrome of the heart that manifests in patients recovering from heart surgery. It is characterized by cardiac arrhythmia, or irregular beating of the heart, caused by abnormal conduction from or through the atrioventricular node. In newborns and infants up to 6 weeks old, the disease may also be referred to as His bundle tachycardia or congenital JET.

<span class="mw-page-title-main">Arrhythmia</span> Group of medical conditions characterized by irregular heartbeat

Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath, chest pain, or decreased level of consciousness. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death.

<span class="mw-page-title-main">Heart development</span> Prenatal development of the heart

Heart development, also known as cardiogenesis, refers to the prenatal development of the heart. This begins with the formation of two endocardial tubes which merge to form the tubular heart, also called the primitive heart tube. The heart is the first functional organ in vertebrate embryos.

The heart is a muscular organ situated in the mediastinum. It consists of four chambers, four valves, two main arteries, and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left side receives saturated blood from the lungs.

Raghib syndrome is rare a congenital heart defect where the left superior vena cava (LSVC) is draining into the left atrium in addition to an absent coronary sinus and an atrial septal defect. This can be considered a dangerous heart condition because it puts the individual at a high risk of stroke. Other defects that are often associated with Raghib syndrome can include ventricular septal defects, enlargement of the tricuspid annulus, and pulmonary stenosis. While this is considered an extremely rare developmental complex, cases regarding a persistent left superior vena cava (PLSVC) are relatively common among congenital heart defects. It is also important to note that the PLSVC often drains into the right atrium, and only drains into the left atrium in approximately 10 to 20% of individuals with the defect.

References

  1. 1 2 Pejković, B; Krajnc, I; et al. (July 2008). "Anatomical Aspects of the Arterial Blood Supply to the Sinoatrial and Atrioventricular Nodes of the Human Heart". Journal of International Medical Research. 36 (4): 691–698. doi: 10.1177/147323000803600410 . PMID   18652764.
  2. Morton, David A. (2018). The Big Picture: Gross Anatomy. K. Bo Foreman, Kurt H. Albertine (2nd ed.). New York. p. 54. ISBN   978-1-259-86264-9. OCLC   1044772257.{{cite book}}: CS1 maint: location missing publisher (link)
  3. Click, Roger L.; Holmes, David R.; et al. (March 1989). "Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival—a report from the coronary artery surgery study". Journal of the American College of Cardiology. 13 (3): 531–537. doi: 10.1016/0735-1097(89)90588-3 . PMID   2918156.
  4. Sánchez-Quintana, D.; Anderson, R. H.; et al. (1 October 2002). "The terminal crest: morphological features relevant to electrophysiology". Heart. 88 (4): 406–411. doi: 10.1136/heart.88.4.406 . PMC   1767383 . PMID   12231604.
  5. Saremi, Farhood; Channual, Stephanie; et al. (June 2008). "MDCT of the S-Shaped Sinoatrial Node Artery". American Journal of Roentgenology. 190 (6): 1569–1575. doi:10.2214/AJR.07.3127. PMID   18492908.