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Heart - Cardiac Veins

Heart - Cardiac Veins

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The cardiac veins carry deoxygenated blood from the myocardium to the right atrium.
  • Cardiac veins are classified by their blood-flow return to the heart:
    • The coronary sinus (and its four major tributaries) drains into the right atrium.
    • The anterior cardiac veins drain directly into the right atrium.
    • The small cardiac veins drain directly into the nearest chamber.
Pathway of venous return to the coronary sinus:
The coronary sinus is a wide, short vessel that drains directly into the right atrium. It runs in the posterior coronary sulcus.
  • Four major tributaries:
    • Great cardiac vein
    • Left posterior ventricular vein
    • Middle cardiac vein
    • Small cardiac vein
Anterior interventricular vein
  • Arises near the apex of the heart and travels superiorly (within the anterior interventricular sulcus).
  • Once it reaches the coronary sulcus, the anterior interventricular vein becomes the great cardiac vein.
    • Travels posteriorly to drain directly into the left end of the coronary sinus (be aware that some texts do not name the anterior interventricular vein separately; instead, they refer to this entire vessel as the great cardiac vein).
Right marginal vein
  • Travels superiorly along the right side of the heart.
  • At the coronary sulcus, the right marginal vein becomes the small cardiac vein.
    • Wraps posteriorly to drain directly into the right end of the coronary sulcus (in some individuals, the right marginal vein drains directly into the right atrium).
Middle cardiac vein
  • Arises near the apex and runs in the posterior interventricular sulcus (hence, it is also called the posterior interventricular vein).
Left posterior ventricular vein
  • Arises between the great and middle cardiac veins.
Anterior cardiac veins
  • Arise on the superior surface of the right ventricle, and drain directly into the right atrium.
Smallest cardiac veins
aka, venae cordis minimae, aka, thebesian veins
  • Valveless vessels that drain directly into the cardiac chambers, particularly the right atrium.
Vein - Artery Associations:
  • The anterior interventricular vein travels with the anterior interventricular artery.
  • The middle cardiac vein travels with the posterior interventricular artery.
  • The small cardiac vein travels with the right coronary artery.
  • The right marginal vein travels with the right marginal artery.
In Summary:
The great cardiac and left posterior ventricular veins drain regions of the myocardium supplied by the left coronary artery; The middle and small cardiac veins drain regions of the myocardium supplied by the right coronary artery.

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