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Coronary circulation diagram

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Here are two authoritative diagrams of the coronary circulation from the medical library:
Fig. 1 - Coronary Arteries (Illustrated) - Guyton and Hall Textbook of Medical Physiology
Coronary arteries diagram showing aorta, pulmonary artery, right coronary artery, left coronary artery, left circumflex branch, and left anterior descending branch
Fig. 2 - Normal Coronary Anatomy (CT Reconstruction) - Textbook of Clinical Echocardiography
CT angiographic 3D reconstruction showing RCA, LAD, PDA, and Circumflex coronary arteries

Coronary Circulation - Key Anatomy

Arterial Supply
ArteryOriginTerritory
Left Main (LM)Left coronary sinus of ValsalvaBifurcates into LAD and Cx
Left Anterior Descending (LAD)Left mainAnterior septum, anterior LV wall, LV apex
Circumflex (Cx)Left mainLateral LV wall (obtuse marginal branches)
Right Coronary Artery (RCA)Right coronary sinus of ValsalvaRight ventricle, posterior LV (in 80-90% of people)
Posterior Descending Artery (PDA)RCA (right dominant, ~80%) or Cx (left dominant, ~20%)Inferior septum, inferior LV free wall
Venous Drainage
  • ~75% of left ventricular coronary venous blood returns via the coronary sinus to the right atrium
  • Right ventricular venous blood drains via anterior cardiac veins directly into the right atrium
  • A small amount returns via thebesian veins directly into all heart chambers
Physiology Highlights (from Costanzo Physiology and Guyton & Hall)
  • Flow is controlled almost entirely by local metabolites - primarily hypoxia and adenosine
  • Resting coronary flow: ~225 mL/min (~4-5% of cardiac output)
  • During strenuous exercise, coronary flow increases 3-4 fold
  • Phasic flow pattern: Left coronary flow is reduced during systole due to myocardial compression, and the bulk of perfusion occurs in diastole - this is why tachycardia (shortened diastole) is dangerous in ischemic heart disease
  • The right coronary artery maintains more continuous flow throughout the cardiac cycle since right ventricular wall tension is lower
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