Which coronary artery supplies the endocardium (inner layer of the heart)?

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From the Guidelines

The left anterior descending (LAD) coronary artery is the primary supplier of blood to the inside of the heart, specifically the interventricular septum. This artery runs down the anterior surface of the heart and gives off septal perforator branches that penetrate and supply the interventricular septum, which is the muscular wall dividing the left and right ventricles. The LAD also supplies the anterior wall of the left ventricle and the anterior portion of the right ventricle. According to the study by 1, the LAD artery is defined as the artery that runs in the anterior interventricular groove and supplies septal perforator branches.

The importance of the LAD artery cannot be overstated, as it supplies crucial components of the heart's electrical conduction system, including parts of the bundle of His and the bundle branches. Blockage of the LAD can lead to serious consequences, including anterior wall myocardial infarction and damage to the conduction system, which is why it's sometimes called the "widow-maker" artery. The right coronary artery and circumflex artery supply other regions of the heart, but the LAD is the primary supplier to the interior septal structures. As noted in the study by 1, the origin and course of the epicardial vessels, including the LAD, should be commented on in reports, particularly if they are anomalous.

Key points to consider when evaluating the coronary arteries include:

  • The LAD artery supplies the interventricular septum and the anterior wall of the left ventricle
  • The right coronary artery and circumflex artery supply other regions of the heart
  • Blockage of the LAD can lead to serious consequences, including anterior wall myocardial infarction and damage to the conduction system
  • The origin and course of the epicardial vessels, including the LAD, should be commented on in reports, particularly if they are anomalous.

From the Research

Coronary Artery Supply to the Inside of the Heart

The coronary artery that supplies the inside of the heart is the left anterior descending artery (LAD).

  • The LAD is a major coronary artery that runs down the front of the heart and supplies blood to the left ventricle, which is the main pumping chamber of the heart 2.
  • The LAD is known to wrap around the apex of the heart in some individuals, and this can have important clinical significance, particularly in patients with anterior ST-segment elevation myocardial infarction (STEMI) 3.
  • The prevalence of the intramyocardial LAD artery, which is a segment of the LAD that dips into the myocardium, has been reported to be around 21.7% in patients undergoing coronary artery bypass grafting (CABG) 4.
  • The angle between the left main coronary artery and the LAD has also been suggested to be a useful predictor of obstructive coronary artery disease, with a wider angle being associated with a higher risk of significant LAD stenosis 5.

Key Findings

  • The LAD is the primary coronary artery responsible for supplying blood to the inside of the heart.
  • The LAD can wrap around the apex of the heart in some individuals, which can have important clinical implications.
  • The intramyocardial LAD artery is a relatively common anatomical variation that can pose a challenge in bypass grafting.
  • The angle between the left main coronary artery and the LAD may be a useful predictor of obstructive coronary artery disease.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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