Specific Considerations with Cardiac Disease - Coronary Anatomy
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The coronary arteries perfuse the myocardium. The left and right coronary arteries originate from the coronary sinuses distal to the aortic valve. The left main coronary artery (LMCA) branches into the left anterior descending artery (LAD) and the left circumflex artery (LCX) to supply most of the left ventricle (LV), interventricular septum (IVS), and the left atrium (LA). The right coronary artery (RCA) supplies the right atrium (RA) and ventricle (RV). It also supplies portions of the IVS, including the sinoatrial (SA) and atrioventricular (AV) nodes (Fig. 2.1). In approximately 70% of the population, the posterior descending artery (PDA) is supplied by the RCA. This circulation is described as “right dominant.” The remainder of the population is either “left dominant,” with the PDA emerging from the LCX (10% of the population), or “codominant,” with the PDA receiving contributions from both the LCX and RCA (20% of population).