Location:
The right coronary artery emerges from the aorta into the AV groove. It
descends through the groove, then curves posteriorly, and makes a bend at
the crux of the heart and continues downward in the posterior
interventricular sulcus. Within millimeters after emerging from the aorta,
the right coronary artery gives off two branches: 1) the conus (arteriosus)
artery which runs to the right ventricular outflow tract, and 2) the atrial
branch which gives off the SA nodal artery (in ~ 50-73% of hearts), which
runs along the anterior right atrium to the superior vena cava, encircling
it before reaching the SA node. The right coronary artery continues in the
AV groove and gives off a variable number of branches to the right atrium
and right ventricle. The most prominent of these is the right marginal
branch which runs down the right margin of the heart supplying this part of
the right ventricle. As the right coronary curves posteriorly and descends
downward on the posterior surface of the heart, it gives off two to three
branches. The AV nodal artery which branches from the right coronary artery
at the crux of the heart and passes anteriorly along the base of the atrial
septum to supply the AV node (in 50-60 % of hearts), proximal parts of the
bundles (branches) of His, and the parts of the posterior interventricular
septum that surround the bundle branches.
Function:
The coronary arteries supply blood to the myocardium (heart tissue) itself;
that is, coronary capillaries deliver oxygenated blood (nutrients) to all of
the heart's cells. Numerous clinically relevant arterial branches arise from
the right coronary artery, including those that supply the conduction system.
Importance in cardiovascular diseases:
Notably, the right coronary artery branches supply the sinus and
atrioventricular nodes; hence, blockage in these vessels can lead to
conduction abnormalities. Coronary artery disease is generally defined as
the gradual narrowing of the lumen of the coronary arteries due to
atherosclerosis. Atherosclerosis is a condition that involves thickening of
the arterial walls via cholesterol and fat deposits that build up along the
endoluminal surface of the arteries. With severe disease, these plaques may
become calcified, increase in size, and eventually cause significant
stenosis; a stenotic vessel has an increased vascular resistance relative to
that of healthy vessels. A steady decrease in arterial cross-sectional area
can eventually lead to complete blockage of the artery. As a result, oxygen
and nutrient supply to the myocardium decreases below the level of demand. As
the disease progresses, the myocardium downstream from the occluded artery
can become ischemic.