The Four Chambers and Basic Heart Anatomy
The human heart has four chambers divided into right and left sides. Each side has an atrium (upper chamber) and a ventricle (lower chamber).
Right Side of the Heart
The right atrium receives deoxygenated blood from your body through two large veins. The superior vena cava brings blood from your upper body. The inferior vena cava brings blood from your lower body.
Blood flows down through the tricuspid valve into the right ventricle. This chamber pumps deoxygenated blood to the lungs via the pulmonary artery.
Left Side of the Heart
The left atrium receives oxygen-rich blood from the lungs through four pulmonary veins. Blood passes through the mitral valve (also called the bicuspid valve) into the left ventricle.
The left ventricle is the heart's most muscular chamber. It pumps oxygenated blood throughout your entire body via the aorta.
Heart Wall Layers
The heart wall contains three distinct layers. The epicardium is the outer layer. The myocardium is the thick muscular layer responsible for contractions. The endocardium is the inner lining.
The entire heart sits inside the pericardium, a protective double-walled sac that reduces friction as the heart beats.
Heart Valves and the Cardiac Cycle
Four valves ensure blood flows in one direction only and prevents backflow. Think of them as one-way doors.
Valve Locations and Names
The tricuspid valve separates the right atrium from the right ventricle. It has three cusps or leaflets. The pulmonary valve sits between the right ventricle and the pulmonary artery.
The mitral valve (bicuspid valve) separates the left atrium from the left ventricle with two cusps. The aortic valve sits between the left ventricle and the aorta.
Valve dysfunction is common in heart disease. Stenosis means the valve narrows and restricts blood flow. Regurgitation means the valve leaks and allows backflow.
The Cardiac Cycle: Systole and Diastole
The cardiac cycle has two main phases. Systole is when the ventricles contract and push blood out of the heart. The atrioventricular valves close to prevent backflow, creating the characteristic "lub" sound.
Diastole is when the ventricles relax and fill with blood from the atria. The semilunar valves close when the ventricles finish contracting, creating the "dub" sound. This is the familiar "lub-dub" heartbeat you hear with a stethoscope.
One complete cardiac cycle takes about 0.8 seconds at a resting heart rate of 75 beats per minute.
The Coronary Circulation and Blood Supply to the Heart
The heart pumps blood to your entire body, but it must also supply oxygen to its own muscle tissue. This is called the coronary circulatory system.
Coronary Arteries
The right and left coronary arteries branch off from the aorta just above the aortic valve. These arteries deliver oxygenated blood directly to the cardiac muscle.
The left coronary artery typically divides into two branches. The left anterior descending artery supplies the front of the heart. The left circumflex artery supplies the side of the heart.
The right coronary artery remains single in most people and supplies the right side and bottom of the heart. These arteries branch extensively across the heart's surface and penetrate deep into the myocardium.
Coronary Sinus and Venous Drainage
Deoxygenated blood from the heart muscle drains into the coronary sinus, which empties directly into the right atrium. This completes the nutrient cycle.
Blocked Coronary Arteries Cause Heart Attacks
Blockages in coronary arteries cause myocardial infarctions (heart attacks). When an artery becomes occluded, the cardiac tissue supplied by that artery becomes starved of oxygen and dies.
The location of the blockage determines which regions are damaged. A left anterior descending artery blockage damages the front of the heart. A right coronary artery blockage damages the bottom.
The Electrical Conduction System and How the Heart Beats
The heart's ability to contract in a coordinated rhythm depends on a sophisticated electrical conduction system. This system generates and propagates electrical signals throughout cardiac tissue.
The Sinoatrial Node (SA Node)
The sinoatrial node (SA node), located in the right atrium near the superior vena cava, serves as the heart's natural pacemaker. The SA node spontaneously generates electrical impulses 60 to 100 times per minute.
When the SA node fires, electrical current spreads across both atria, causing them to contract simultaneously. This is called atrial depolarization.
The Atrioventricular Node (AV Node)
The impulse reaches the atrioventricular node (AV node), located in the lower right atrium. The AV node deliberately delays the signal by about 0.1 seconds.
This delay is crucial. It allows the atria to finish contracting and fully empty their blood into the ventricles before ventricular contraction begins.
The Conduction Pathway to Ventricles
After the AV node delay, the signal travels down the bundle of His. This bundle divides into right and left bundle branches, then spreads through the Purkinje fibers to all ventricular muscle regions.
This sequence ensures the ventricles contract from the apex upward, efficiently pumping blood into the arteries.
Major Blood Vessels and Pulmonary vs. Systemic Circulation
The heart works within a larger circulatory system of arteries, capillaries, and veins. This system delivers oxygen to all body tissues.
Systemic Circulation
The systemic circulation carries oxygenated blood from the left ventricle through the aorta and its branches to all body tissues except the lungs. Arteries carry blood away from the heart under high pressure and have thick muscular walls.
Arteries branch into smaller arterioles and then capillaries where gas exchange occurs. Deoxygenated blood returns via venules and veins, which have thinner walls and lower pressure.
The superior vena cava collects blood from the upper body. The inferior vena cava collects blood from the lower body. Both drain into the right atrium.
Pulmonary Circulation
The pulmonary circulation is separate and shorter. It carries deoxygenated blood from the right ventricle through the pulmonary artery to both lungs for oxygenation.
Oxygenated blood returns from the lungs via four pulmonary veins that drain into the left atrium.
Why the Two Circulations Matter
The heart acts like two pumps working in series. The right side pumps blood to the lungs at low pressure. The left side pumps blood throughout the body at higher pressure.
