anatomy of the coronary arteries

Last reviewed 01/2018

The arterial supply of the heart is provided by the right and left coronary arteries. They arise from the aorta immediately distal to the aortic valve from the right and left aortic sinuses, respectively. Initially, the two main arteries run in the atrioventricular groove on either side of the pulmonary trunk. They give off multiple, fine branches - see submenu.

On the superficial surface of the heart, there are several points of anastomosis between arterioles of the right and left coronary arteries e.g. between the anterior and posterior interventricular arteries in the posterior interventricular groove. Also, there are multiple anastomoses between:

  • both main arteries within the interventricular septum
  • both coronary arteries and pericardial arteries at the superior margin of the heart

However, over most of the heart each branch is effectively an end artery supplying a unique region of myocardium. Even in regions with relatively dense anastomoses, if there is rapid occlusion of vessels there may not be time for collateral channels to compensate. Ischaemia and infarction result.

Anomalies of distribution are relatively common. The veins which accompany the arteries do not have the same names.