• The Heart

6000 liters of blood/day

30-40 million times a year
 Cardiac Structure and Specializations
• Weighs approx. 0.4% to 0.5% of body weight
– 250 - 320 gm in females
– 300 - 360 gm in males
• RV- 0.3-0.5 cm wall thicknness
• LV- 1.3-1.5 cm thick
• Hypertrophy- increases heart weight or
ventricular thickness
• Dilation- enlarge chamber size
• Cardiomegaly- hypertrophy and/or dilation
Myocardium
Myocardium
Atrial myocytes
- relatively haphazardly arranged
- generate weaker contractile forces than the
Atrial natriuretic peptide
- peptide hormone that promotes arterial
vasodilatations and stimulates renal salt and
water elimination (natriuresis and diuresis) ,
- beneficial-hypertension and congestive heart
failure
Intercalated discs
- specialized intercellular functions that
facilitate cell-to-cell mechanical and electrical
 4 Cardiac Valves

-Tricuspid
- Mitral
- Pulmonary
- Aortic

—maintain unidirectional blood flow valve. Function depends on the

mobility, pliability, and structural integrity of the leaflets of the
atrioventricular valves, (tricuspid and mitral) or cusps of the semilunar
valves, (aortic and pulmonary)
Atrioventricular valves- depends on the
Semilunar valves - depends on the
proper function not only the lealets but
integrity and coordinated movements of the
also the tendinous cords and the
cuspal attachments
attached papillary muscles of the
-valvular regurgitation
ventricular wall
-valvular insufficiency
Fibrosa- dense collagenous core at the outflow surface and connected to
the valvular supporting Structures

Spongiosa-central core of loose connective tissue

Ventricularis or atrialis-layer rich in elastin on the inflow surface

-collagen of the ventricularis is largely responsible for the
mechanical integrity of a valve
-elastic tissue of the atrialis/ventricularis imparts a rapid recoil to
achieve prompt valve closure
• Valvular interstitial cells
– most abundant cell type in the heart valves
– synthesize extracellular matrix (ECM) and
express matrix and degrading enzymes
(including matrix metalloproteinases[MMPs]
 Pathological changes of valves
• Damage to collagen
that weakens the
leaflets
–Exemplified by
mitral valve
prolapse
• Nodular calcification
beginning in the
interstitial cell
–As in calcific aortic
 Pathological changes of valves
• Damage to collagen
that weakens the
leaflets
–Exemplified by
mitral valve
prolapse
• Nodular calcification
beginning in the
interstitial cell
–As in calcific aortic
stenosis
Conduction system
• Contraction of the cardiac
muscle depends on
propagation of electrical
impulses—accomplished
through specialized
excitatory and conducting
myocytes within the
cardiac conduction
system that regulate
heart rate and rhythm
• Components:
– Sinoatrial node-
pacemaker (60 to 100
beats/minute)
 Blood supply
* Coronary arteries
* Epicardial coronary arteries
* Intramural arteries

3 Major Epicardial
artery:
– Left anterior
descending-
diagonal branches
– And Left circumflex
arteries-marginal
branches
– Right coronary
artery- end arteries,
• Cardiac Dysfunction:
• Cardiovascular disease
– Coronary artery disease
– Stroke
– Peripheral vascular disease
• Congenital heart disease
• Ischemic heart disease
• Diseases of the cardiac valves
• Primary myocardial disorder
• Pericardial diseases
• Cardiac neoplasm