Anatomia Serca | Heart Anatomy

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“Strokes”: “Udar mózgu”, “Mediastinum”: “Śródpiersie”, “Thoracic cavity”: “Jama klatki piersiowej”, “Lungs”: “Płuca”, “Sternum”: “Mostek”, “Vertebral column”: “Kręgosłup”, “Left lung”: “Lewe płuco”, “Midline”: “Linia pośrodkowa”, “Apex of the heart”: “Wierzchołek serca”, “Diaphragm”: “Przepona”, “Base of the heart”: “Podstawa serca”, “Pulmonary veins”: “Żyły płucne”, “Thoracic anatomy”: “Anatomia klatki piersiowej”, “External anatomy of the heart”: “Zewnętrzna anatomia serca”, “Apex”: “Wierzchołek”, “Base”: “Podstawa”, “Great vessels”: “Wielkie naczynia”, “Aorta”: “Aorta”, “Pulmonary arteries”: “Tętnice płucne”, “Superior vena cava”: “Żyła główna górna”, “Inferior vena cava”: “Żyła główna dolna”, “Pericardium”: “Osierdzie”, “Fibrous pericardium”: “Osierdzie włókniste”, “Serous pericardium”: “Osierdzie surowicze”, “Parietal layer”: “Blaszka ścienna”, “Visceral layer”: “Blaszka trzewna”, “Pericardial cavity”: “Jama osierdzia”, “Pericardial fluid”: “Płyn osierdziowy”, “Coronary sulcus”: “Bruzda wieńcowa”, “Atrioventricular groove”: “Bruzda przedsionkowo-komorowa”, “Interventricular sulci”: “Bruzdy międzykomorowe”, “Anterior interventricular artery”: “Tętnica międzykomorowa przednia”, “Posterior interventricular artery”: “Tętnica międzykomorowa tylna”, “Heart wall”: “Ściana serca”, “Epicardium”: “Nasierdzie”, “Myocardium”: “Mięsień sercowy”, “Cardiomyocytes”: “Kardiomiocyty”, “Intercalated discs”: “Wstawki”, “Gap junctions”: “Połączenia szczelinowe”, “Desmosomes”: “Desmosomy”, “Endocardium”: “Wsierdzie”, “Heart chambers”: “Jam serca”, “Right atrium”: “Prawy przedsionek”, “Left atrium”: “Lewy przedsionek”, “Right ventricle”: “Prawa komora”, “Left ventricle”: “Lewa komora”, “Heart valves”: “Zastawki serca”, “Atrioventricular valves”: “Zastawki przedsionkowo-komorowe”, “Tricuspid valve”: “Zastawka trójdzielna”, “Mitral valve”: “Zastawka mitralna”, “Bicuspid valve”: “Zastawka dwudzielna”, “Semilunar valves”: “Zastawki półksiężycowate”, “Pulmonary valve”: “Zastawka płucna”, “Aortic valve”: “Zastawka aortalna”, “Chordae tendineae”: “Struny ścięgniste”, “Papillary muscles”: “Mięśnie brodawkowate”, “Heart sounds”: “Tony serca”, “S1”: “Pierwszy ton serca”, “S2”: “Drugi ton serca”, “Coronary circulation”: “Krążenie wieńcowe”, “Coronary arteries”: “Tętnice wieńcowe”, “Left coronary artery”: “Lewa tętnica wieńcowa”, “Right coronary artery”: “Prawa tętnica wieńcowa”, “Cardiac veins”: “Żyły serca”, “Coronary sinus”: “Zatoka wieńcowa”, “Conducting system of the heart”: “Układ przewodzący serca”, “Sinoatrial node”: “Węzeł zatokowo-przedsionkowy”, “Atrioventricular node”: “Węzeł przedsionkowo-komorowy”, “Bundle of His”: “Pęczek Hisa”, “Right bundle branch”: “Prawa odnoga pęczka Hisa”, “Left bundle branch”: “Lewa odnoga pęczka Hisa”, “Purkinje fibers”: “Włókna Purkinjego”, “Congenital heart defects”: “Wrodzone wady serca”, “Atrial septal defect”: “Ubytek przegrody międzyprzedsionkowej”, “Ventricular septal defect”: “Ubytek przegrody międzykomorowej”, “Patent ductus arteriosus”: “Przetrwały przewód tętniczy”, “Coarctation of the aorta”: “Koarktacja aorty”, “Pulmonary stenosis”: “Zwężenie tętnicy płucnej”, “Aortic stenosis”: “Zwężenie zastawki aortalnej”, “Tetralogy of Fallot”: “Tetralogia Fallota”, “Cyanosis”: “Sinica”, “Right ventricular hypertrophy”: “Przerost prawej komory”, “Overriding aorta”: “Aorta jeździec”, “Inner lining”: “Wewnętrzna wyściółka”, “Blood pressure”: “Ciśnienie krwi”, “Anteriorly”: “Z przodu”, “Connective tissue”: “Tkanka łączna”, “Atria”: “Przedsionki”, “Ventricles”: “Komory”, “Left anterior descending artery”: “Lewa tętnica zstępująca przednia”, “Cusps”: “Płytki zastawkowe”, “Tricuspid”: “Trójdzielna”, “Mitral”: “Mitralna”, “Mitral valves”: “Zastawki mitralne”, “Aortic”: “Aortalna”, “Pulmonary valves”: “Zastawki płucne”, “Great cardiac vein”: “Żyła wielka serca”, “Middle cardiac vein”: “Żyła średnia serca”, “Small cardiac vein”: “Żyła mała serca”, “Fifth intercostal space”: “Piąta przestrzeń międzyżebrowa”, “Dilation”: “Rozszerzenie”, “Endothelial cells”: “Komórki śródbłonka”, “Myocardial contraction”: “Skurcz mięśnia sercowego”, “Pulmonary circulation”: “Krwioobieg płucny”, “Oxygenated”: “Natlenowana”, “Deoxygenated”: “Odtlenowana”, “Systole”: “Skurcz serca (systole)”, “Valve leaflets”: “Płatki zastawki”, “Sinoatrial (SA) Node”: “Węzeł zatokowo-przedsionkowy (SA)”, “Atrioventricular (AV) Node”: “Węzeł przedsionkowo-komorowy (AV)”, “Atrial wall”: “Ściana przedsionka”, “Interatrial septum”: “Przegroda międzyprzedsionkowa”, “Interventricular septum”: “Przegroda międzykomorowa”, “Fibers”: “Włókna”, “Bundle branches”: “Odnogi pęczka Hisa”, “Fetal life”: “Życie płodowe”, “Congenital anomalies”: “Wady wrodzone”, “Fatigue”: “Zmęczenie”, “Shortness of breath”: “Dusznica (brak tchu)”, “Arrhythmias”: “Arytmie”, “Cyanotic”: “Siniczy”, “Non-cyanotic”: “Niesiniczy”, “Pulmonary hypertension”: “Nadciśnienie płucne”, “Ductus arteriosus”: “Przewód tętniczy”, “Pulmonary artery”: “Tętnica płucna”, “Catheter-based procedures”: “Zabiegi z użyciem cewnika”, “Ventricular hypertrophy”: “Przerost komory”, “Balloon valvuloplasty”: “Walwuloplastyka balonowa”, “Surgery”: “Operacja”, “Valve replacement”: “Wymiana zastawki”, “Stenosis”: “Zwężenie”, “Percutaneous”: “Przezskórny”, “Heart failure”: “Niewydolność serca” }; // Normalize keys in the dictionary const normalizedWordsToTooltip = {}; for (const [key, value] of Object.entries(wordsToTooltip)) { const cleanedKey = key.replace(/(.*?)/g, ”).trim(); // Remove anything in parentheses normalizedWordsToTooltip[cleanedKey.toLowerCase()] = value; } function processNode(node) { if (node.nodeType === Node.TEXT_NODE && node.nodeValue.trim()) { let content = node.nodeValue; // Regex to match only the main words (ignores parentheses) const regex = new RegExp( `b(${Object.keys(normalizedWordsToTooltip).join(‘|’)})b`, ‘gi’ ); if (regex.test(content)) { const wrapper = document.createElement(‘span’); wrapper.innerHTML = content.replace(regex, (match) => { const 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Location and Position of the Heart

The heart is located in the mediastinum, the central compartment of the thoracic cavity. This cavity is situated between the lungs and is bordered anteriorly by the sternum and posteriorly by the vertebral column. The heart’s location is slightly to the left of the midline, which accounts for the smaller size of the left lung compared to the right, allowing space for the heart.

The apex of the heart, the pointed lower end, is directed downward and to the left, making contact with the diaphragm. In contrast, the base of the heart is positioned superiorly and posteriorly. This anatomical orientation is crucial for proper heart function

External Anatomy of the Heart

The external structure of the heart plays a critical role in its ability to perform efficient circulation and serves as the anchor point for major vessels and supporting anatomical features. Understanding the external anatomy is vital for comprehending how the heart integrates with the cardiovascular system as a whole.

Apex and Base

• Base: The base is the superior, broader region of the heart. It serves as the site of attachment for the great vessels, including the aorta, pulmonary arteries, superior vena cava, and inferior vena cava. The base primarily consists of the left atrium and a small portion of the right atrium. Its posterior positioning allows for optimal interaction with pulmonary structures, such as the pulmonary veins.
• Apex: The apex of the heart is the pointed, inferior part of the heart that angles downward and to the left, resting on the diaphragm. The apex is primarily formed by the tip of the left ventricle and is responsible for generating the apex beat, which can be felt in the fifth intercostal space during palpation.

Pericardium 

The pericardium is the protective sac that surrounds the heart. It is composed of two main layers: fibrous pericardium and serous pericardium.

• Fibrous Pericardium: This tough, dense, inelastic layer of connective tissue anchors the heart to the diaphragm, sternum, and the great vessels. It acts as a protective barrier that limits excessive heart dilation during overfilling, thereby preventing overexpansion.
• Serous Pericardium: The serous pericardium is divided into two layers:
  • Parietal Layer: The outer layer lining the fibrous pericardium.
  • Visceral Layer (Epicardium): The inner layer that closely adheres to the myocardium. It provides a smooth external surface for the heart and is also considered part of the heart wall.
• Pericardial Cavity: Located between the parietal and visceral layers of the serous pericardium, this cavity contains a small volume of pericardial fluid—approximately 15-50 mL. This fluid acts as a lubricant, allowing frictionless movement of the heart as it beats and shifts within the thoracic cavity.

Coronary Sulci

The external surface of the heart has multiple sulci, or grooves, which mark the division of the chambers and contain essential coronary vessels.

• Coronary Sulcus (Atrioventricular Groove): This sulcus encircles the heart horizontally, separating the atria from the ventricles. The coronary sulcus houses major coronary arteries and veins, such as the right coronary artery and circumflex artery.
• Anterior and Posterior Interventricular Sulci: These vertical grooves are located between the ventricles on both the anterior and posterior surfaces of the heart. They contain the anterior interventricular artery (left anterior descending artery, LAD) and the posterior interventricular artery, which are crucial for supplying the interventricular septum and adjacent ventricular walls.

Cardiac Layers

The heart wall is made up of three distinct layers, each playing a crucial role in the function of the heart:

• Epicardium: The thin, outermost layer of the heart wall, synonymous with the visceral layer of the serous pericardium. It provides a protective surface that contains blood vessels, nerves, and fat to supply the myocardium.
• Myocardium: The muscular middle layer of the heart wall. It is composed of specialized cardiac muscle cells, or cardiomyocytes, which contract in a rhythmic and involuntary manner. The myocardium’s thickness varies, with the left ventricle having the thickest myocardium to sustain the pressure needed for systemic circulation. The intercalated discs connecting cardiomyocytes contain gap junctions and desmosomes that facilitate rapid electrical conduction and strong adhesion between cells, respectively.
• Endocardium: The innermost layer of the heart wall, consisting of a smooth layer of endothelial cells that lines the heart chambers and covers the valves. This smooth lining reduces friction, allowing for efficient blood flow, and contributes to the regulation of myocardial contraction and overall cardiac function.

Internal Anatomy of the Heart

The internal structure of the heart is comprised of four chambers—two atria and two ventricles. The structural design of these chambers reflects their distinct functional roles in receiving and pumping blood.

Chambers of the Heart

The heart has four chambers divided into atria and ventricles, each playing a crucial role in blood circulation. The atria are the heart’s receiving chambers, while the ventricles are the pumping chambers.

Chamber	Description
Right Atrium	Receives deoxygenated blood from the body through the superior and inferior vena cavae. The coronary sinus also drains blood from the heart’s own circulation into the right atrium.
Left Atrium	Receives oxygenated blood from the lungs via the pulmonary veins and acts as a reservoir, allowing continuous blood flow into the left ventricle.
Right Ventricle	Pumps deoxygenated blood to the lungs through the pulmonary artery. Its walls are relatively thin because less pressure is required for pulmonary circulation.
Left Ventricle	Pumps oxygenated blood into the systemic circulation through the aorta. It has a thicker myocardium compared to the right ventricle, reflecting the greater force needed to circulate blood throughout the body.

Heart Valves

Valves are essential for maintaining one-way blood flow through the heart, and they operate in response to pressure differences across chambers.

Atrioventricular (AV) Valves

• Tricuspid Valve: Situated between the right atrium and right ventricle, the tricuspid valve consists of three cusps or leaflets. It prevents backflow of blood into the right atrium during ventricular contraction.
• Mitral Valve (Bicuspid Valve): Positioned between the left atrium and left ventricle, the mitral valve has two cusps. It prevents regurgitation of blood into the left atrium during systole.

Semilunar Valves

• Aortic Valve: Found between the left ventricle and aorta, the aortic valve consists of three cusps and prevents blood from re-entering the left ventricle following systole.
• Pulmonary Valve: Located between the right ventricle and the pulmonary trunk, the pulmonary valve prevents backflow into the right ventricle after blood is ejected to the lungs.

Chordae Tendineae and Papillary Muscles

• The chordae tendineae are tendon-like structures that anchor the cusps of the AV valves to the papillary muscles found on the inner ventricular walls. During ventricular contraction, the papillary muscles contract, pulling the chordae tendineae tight, which prevents the valve leaflets from prolapsing back into the atria.

Heart Sounds

Heart sounds are produced by the closure of the heart valves:

• S1 (First Heart Sound): Produced by the closure of the tricuspid and mitral valves at the onset of ventricular systole.
• S2 (Second Heart Sound): Produced by the closure of the aortic and pulmonary valves at the beginning of diastole.

Coronary Circulation

The heart muscle itself requires a rich blood supply to function efficiently. This is accomplished through the coronary arteries and veins.

• Coronary Arteries: These arteries branch from the ascending aorta and include the left coronary artery (which divides into the anterior interventricular artery and the circumflex artery) and the right coronary artery (which gives rise to the right marginal artery and the posterior interventricular artery).
• Cardiac Veins: Deoxygenated blood from the myocardium is collected by cardiac veins (e.g., the great cardiac vein, middle cardiac vein, and small cardiac vein) and drained into the coronary sinus, which empties into the right atrium.

Conducting System of the Heart

The heart’s conduction system is composed of a network of specialized structures located throughout the heart.

• Sinoatrial (SA) Node: A cluster of specialized cells situated in the right atrial wall near the opening of the superior vena cava.
• Atrioventricular (AV) Node: Positioned at the lower part of the interatrial septum, near the boundary between the atria and the ventricles.
• Bundle of His: A collection of fibers that originates from the AV node and travels along the upper part of the interventricular septum, where it divides into two branches:
  • Right Bundle Branch: Runs along the right side of the interventricular septum.
  • Left Bundle Branch: Extends along the left side of the interventricular septum.
• Purkinje Fibers: A network of fibers that branch off from the right and left bundle branches, spreading extensively throughout the ventricular walls.

Common Congenital Heart Defects

Congenital heart defects are structural abnormalities of the heart and its major vessels that develop during fetal life. These conditions affect approximately 1 in 100 children worldwide and are among the most common congenital anomalies. Although some defects are asymptomatic, many can significantly impact health, especially as they may reduce the heart’s ability to pump oxygenated blood effectively. Symptoms vary depending on the defect type and individual health but can include fatigue, shortness of breath, cyanosis, and arrhythmias. Heart defects are categorized into simple and complex types, as well as cyanotic (resulting in cyanosis) and non-cyanotic forms.

Congenital Heart Defect	Description
Atrial Septal Defect (ASD)	ASD is a defect in the septum between the atria, allowing blood to flow between them. It is often asymptomatic until adulthood, when symptoms such as reduced exercise tolerance, shortness of breath, or arrhythmias may appear. In many cases, treatment involves percutaneous closure of the defect.
Ventricular Septal Defect (VSD)	A hole in the septum between the ventricles, VSD can vary in size and often requires surgical closure in larger defects to prevent heart failure or pulmonary hypertension. Smaller VSDs may remain asymptomatic and close spontaneously.
Patent Ductus Arteriosus (PDA)	PDA is an abnormal persistence of the ductus arteriosus, a fetal blood vessel, leading to abnormal blood flow between the aorta and pulmonary artery. Small PDAs may close on their own, while larger ones can cause symptoms and require closure via catheter-based procedures or surgery.
Coarctation of the Aorta (CoA)	A narrowing of the aorta, CoA can lead to high blood pressure and left ventricular hypertrophy. Symptoms may be minimal in mild cases, but severe narrowing typically requires surgical intervention to restore normal blood flow.
Pulmonary Stenosis (PS)	PS is a narrowing of the pulmonary valve or artery, restricting blood flow from the right ventricle to the lungs. Mild cases are often asymptomatic, while more severe stenosis can cause fatigue and shortness of breath, necessitating balloon valvuloplasty or surgery.
Aortic Stenosis (AS)	A narrowing of the aortic valve restricts blood flow from the left ventricle to the aorta. While mild AS may not produce symptoms, severe cases can lead to fatigue, shortness of breath, and require surgical repair or valve replacement.
Tetralogy of Fallot (ToF)	A complex defect that includes VSD, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. ToF is cyanotic, often causing blue skin discoloration due to low blood oxygen levels. Surgical correction is typically required early in life to improve oxygenation.