I. Learning unit: Myocardial infarction and its complications

Objectives and competencies

In this curriculum students may learn development and complications of myocardial infarction in multidisciplinary approach. The anatomical chapter describes course and branches of the coronary arteries and territorial blood supply of the heart. Pathological implications include etiology and mechanism of myocardial infarction and complications. Students may read about arteriosclerosis as the most important predilection factor of myocardial infarction and other important risk factor such as high blood pressure or ischemic heart disease. The radiological chapter recaps important appearance of myocardial infarction on CT and MR imaging and other such as echocardiography or coronarography. The clinical chapter allows student to learn more about epidemiology symptoms diagnosis, differential diagnosis, and clinical course and in an environment enriched with illustrations photos and tables.

I./1. chapter: Blood supply of the human heart – Normal anatomy of the coronary arteries

Ágnes Nemeskéri

The chapter structure

I./1.1.: Coronary arteries - in general

I./1.2.: Right coronary artery (a. coronaria dextra)

I./1.2.1.: Right coronary artery – in general

I./1.2.2.: Segments of the RCA

I./1.2.3.: Branches of the RCA

I./1.2.3.1.: Main stem of the RCA - Branches from the first segment of the RCA

• - Right conus branch (r. [dexter] coni arteriosi)

• - Right superior descending artery - right superior septal - descending septal artery (a. descendens superior dextra)

• - Right anterior ventricular branches (rr. anteriores ventriculi dextri)

• - Right marginal branch – acute marginal branch (r. marginalis dexter)

• - Atrial branches – Right anterior atrial branches (rr. atriales dextri anteriores)

• - Atrial branches – Right sinuatrial nodal artery (a. nodi sinuatrialis [dextra])

I./1.2.3.2.: Branches from the second segment of the RCA

• - Right posterior ventricular branches (rr. posteriores ventriculi dextri)

• - Right atrioventricular nodal artery (a. nodi atrioventricularis [dextra])

• - Right posterior atrial branch (r. atrialis dexter posterior)

I./1.2.3.3.: In right dominant coronary systems:

• - Posterior interventricular artery – right posterior descending artery (a. interventricularis posterior)

• - Right posterior branches of the left ventricle

• - Right ventricular posterolateral branch (r. posterolateralis ventriculi sinistri)

I./1.3.: Left coronary artery (a. coronaria sinistra)

• I./1.3.1.: Left coronary artery (a. coronaria sinistra) – in general

• I./1.3.2.: Segments of the LCA

• I./1.3.3.: Branches of the LCA

• 1. Main stem of the LCA (truncus proximalis arteriae coronariae sinistrae)

• 2. Anterior interventricular artery – left anterior descending artery (a. interventricularis anterior)

  • - Left conus branch (r. sinister coni arteriosi)

  • - Diagonal branches (rr. diagonales)

  • - Right anterior ventricular branches (rr. anteriores ventriculi dextri)

  • - Anterior septal branches (rr. interventricularis septalis anteriores)

• 3. Circumflex artery (r. circumflexus) - Segments of the circumflex artery

  • - Lateral diagonal branches (rr.diagonales laterales)

  • - Left marginal branch – obtuse marginal branch (rr. marginalis sinistri)

  • - Posterior branch of the left ventricle (r. posterior ventriculi sinistri)

  • - Left sinuatrial nodal artery (r. nodi sinuatrialis [sinister])

  • - Left lateral atrial branches (rr. atriales sinistri laterales)

  • - Left marginal atrial branch (r. atrialis sinister marginalis)

  • - Left posterior atrial branches (rr. atriales sinistri posteriores)

  • - In left dominant coronary systems:

• 5. Intermediate branch(es)

I./1.4.: Coronary dominance

References