koronarkärl

Koronarkärl, or coronary vessels, are the network of arteries and veins that supply the heart muscle (myocardium) with oxygenated blood and remove metabolic waste. They originate from the aorta just above the aortic valve and form a circulation dedicated to the heart’s own perfusion.

The major arteries are the left coronary artery and the right coronary artery. The left coronary artery typically arises from the left aortic sinus and quickly divides into the left anterior descending (LAD) artery, which runs along the front of the heart, and the circumflex (LCx) artery, which travels in the left atrioventricular groove. The right coronary artery emerges from the right aortic sinus and travels in the right atrioventricular groove, giving off marginal branches and often the posterior descending artery in right-dominant circulations. Variations in dominance and branching patterns are common.

Venous drainage is carried by the coronary veins, which converge into the coronary sinus and drain into the right atrium. The venous system parallels the arterial supply to a large extent, with the great, middle, and small cardiac veins being the principal collectors.

Coronary perfusion occurs predominantly during diastole, as myocardial contraction during systole compresses intramyocardial vessels. Perfusion pressure is influenced by aortic pressure and right atrial pressure.

Clinical relevance centers on coronary artery disease, typically due to atherosclerosis, which can reduce blood flow and cause angina or myocardial infarction. Diagnosis and treatment involve imaging (ECG, coronary angiography or CT), pharmacotherapy (antiplatelets, statins, nitrates, beta-blockers), and interventions such as percutaneous coronary intervention or bypass surgery.