Coronary

Coronary refers to the heart and to the vessels and structures that supply blood to the heart muscle. In medical terminology, the term most often denotes the coronary circulation, the network of arteries and veins that nourishes the myocardium and maintains its function. The word originates from the Latin cor, meaning heart, and in anatomy is used to distinguish structures around the heart from those of the chest wall or mediastinum.

Anatomy and circulation: The two main coronary arteries arise from the aorta just above the aortic valve. The left coronary artery divides into the left anterior descending (LAD) artery and the left circumflex (LCx) artery, which run in the interventricular and atrioventricular grooves. The right coronary artery originates from the right aortic sinus and travels in the right coronary sulcus, supplying the right atrium, right ventricle, and often the inferior portion of the left ventricle. Cardiac veins parallel the arteries and drain into the coronary sinus, which empties into the right atrium. Perfusion of the myocardium occurs predominantly during diastole, when the heart muscle is relaxed.

Dominance and variation: Coronary dominance describes which artery gives rise to the posterior descending artery; in most people, this is the right coronary artery, while a minority have left-dominant circulation. Anatomical variations are common and have clinical implications for imaging and surgical planning.

Disease and treatment: Coronary artery disease arises from atherosclerotic plaque within the coronary arteries, reducing blood flow and potentially causing angina or myocardial infarction. Risk factors include age, smoking, hypertension, hyperlipidemia, diabetes, obesity, and family history. Diagnosis involves ECG, stress testing, echocardiography, and coronary angiography or CT imaging. Management includes lifestyle modification, antiplatelet therapy, statins, and risk-factor control; revascularization may be achieved with PCI or CABG. The term also appears in related structures such as the coronary sulcus and coronary sinus.