Histology – Wall layering
The wall layers are the same in all four heart interiors:
- The innermost layer is the endocardium, consisting of a single-layer epithelium, which is supported by the connective tissue lamina propria.
- The muscle layer (myocardium) is connected to the outside of this.
- The outermost layer is the epicardium.
Blood supply
The heart is supplied with blood via the coronary arteries (coronary vessels, Vasa coronaria). These are formed by the two main vessels, the left and right coronary arteries (arteria coronaria sinistra and dextra) and their numerous branches. These branches emerge from the aorta immediately after it exits the heart. The left ventricle is mainly supplied by branches of the left coronary artery, but a small part of the supply is also provided by the right coronary artery.
Clinical aspects
A cardiac insufficiency means a muscle weakness due to which the pumping capacity of the heart is no longer sufficient to supply the body with sufficient oxygen. As a result, more and more blood accumulates in front of the affected heart section.In left heart failure, this congestion is most noticeable in the form of pulmonary edema, i.e. the accumulation of water in the lungs. Such pulmonary edema typically causes breathing difficulties (dyspnoea).
Another symptom of heart failure is – among others – a decrease in physical performance. Causes can be, for example: Ventricular septal defects are relatively common congenital malformations in which there is an opening in the ventricular septum. There is therefore a short circuit (shunt) between the left and right ventricle.
This means that oxygen-saturated blood from the left ventricle is not only ejected into the aorta, but is also pumped back into the right ventricle (left-right shunt). This leads to an increased load on the left ventricle, as it now has to do more work to pump the required volume into the body’s circulation. This results in heart hypertrophy (increase in thickness of the heart wall). To prevent this, larger ventricular septal defects are corrected surgically.
- Congenital valve defects,
- But also be an expired heart attack.
