Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T17:59:45.299Z Has data issue: false hasContentIssue false

Chapter 1 - The Anatomy of the Normal Heart

Published online by Cambridge University Press:  19 August 2019

Michael T. Ashworth
Michael T. Ashworth
Affiliation:
Great Ormond Street Hospital for Children, London
Get access

Summary

This chapter examines the structure of the normal heart at the gross, microscopic and ultrastructural levels. The pericardium, myocardium, endocardium, valves, arteries, veins, lymphatics, nerves and conduction system are described in detail, together with common variants of normal. References are given to normal values for heart measurements throughout gestation, infancy and childhood.

Keywords

normalatriumventriclevalveveinarteryhistologyelectron-microscopy
Type
Chapter
Information
Pathology of Heart Disease in the Fetus, Infant and Child
Autopsy, Surgical and Molecular Pathology
 , pp. 1 - 32
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cabrera, JA, Sanchez-Quintana, D, Ho, SY, Medina, A, Anderson, RH. The architecture of the atrial musculature between the orifice of the inferior caval vein and the tricuspid valve: the anatomy of the isthmus. J Cardiovasc Electrophysiol 1998; 9: 1186–1195.Google Scholar
Jones, RN, Niles, NR. Spinnaker formation of sinus venosus valve. Circulation 1968; 38: 468–473.Google Scholar
Doucette, J, Knoblich, R. Persistent right valve of the sinus venosus. Arch Pathol 1963; 75: 105–112.Google ScholarPubMed
Arey, JB. Embryology of the heart and great vessels. In Cardiovascular Pathology in Infants and Children. Philadelphia: WB Saunders; 1984, p. 25.Google Scholar
Restivo, A, Smith, A, Wilkinson, JL, Anderson, RH. The medial papillary muscle complex and its related septomarginal trabeculation. A normal anatomical study on human hearts. J Anat 1989; 163: 231–243.Google Scholar
Rosenquist, GC, Clark, EB, Sweeney, LJ, McAllister, HA. The normal spectrum of mitral and aortic valve discontinuity. Circulation.1976; 54: 298–301.CrossRefGoogle ScholarPubMed
Pomerance, A. Atheroma of the mitral valve. J. Atheroscler Res 1967; 7: 151–160.Google Scholar
Rosenquist, GC, Sweeny, LJ, Amsel, J et al. Enlargement of the membranous ventricular septum: an internal stigma of Down’s syndrome. J Pediatr 1974; 85: 490–493.Google Scholar
Jouk, PS, Usson, Y, Michalowicz, G, Grossi, L. Three-dimensional cartography of the pattern of the myofibres in the second trimester fetal human heart. Anat Embryol 2000; 202: 103–118.CrossRefGoogle ScholarPubMed
Anderson, RH, Ho, SY, Smith, A et al. Study of the cardiac conduction tissues in the paediatric age group. Diagn Histopathol 1981; 4: 3–15.Google Scholar
Blom, NA, Gittenberger-de, Groot AC, DeRuiter, MC et al. Development of the cardiac conduction tissue in human embryos using HNK-1 antigen expression: possible relevance for understanding of abnormal atrial automaticity. Circulation. 1999; 99: 800–806.Google Scholar
Anderson, RH, Ho, SY, Smith, A, Becker, AE. The internodal atrial myocardium. Anat Rec 1981; 201: 75–82.Google Scholar
James, TN. Cardiac conduction system: fetal and postnatal development. Am J Cardiol 1970; 25: 213–226.Google Scholar
Moulaert, AJ, Oppenheimer-Dekker, A. Anterolateral muscle bundle of the left ventricle, bulboventricular flange and subaortic stenosis. Am J Cardiol 1976; 37: 78–81.Google Scholar
Anderson, RH. Surgical anatomy of the coronary circulation. In Wilcox, BR, Cook, AC, Anderson, RH (eds) Surgical Anatomy of the Heart, 3rd edn. Cambridge: Cambridge University Press; 2004, pp. 84–85.Google Scholar
Schlesinger, MJ, Zoll, PM, Wessler, S. The conus artery: a third coronary artery. Am Heart J 1949; 38: 823–826.Google Scholar
Garg, A, Ogilvie, BC, McLeod, AA. Anomalous origin of the left coronary artery from the non-coronary sinus of Valsalva. Heart 2000; 84: 136.Google Scholar
Spicer, DE, Henderson, DJ, Chaudhry, B, Mohun, TJ, Anderson, RH. The anatomy and development of normal and abnormal coronary arteries. Cardiol Young 2015; 25: 1493–1503.CrossRefGoogle ScholarPubMed
von Lüdinghausen, M. The venous drainage of the human myocardium. Adv Anat Embryol Cell Biol 2003; 168: I–VIII, 1–104.Google Scholar
Loukas, M, Bilinsky, S, Bilinsky, E, el-Sedfy, A, Anderson, RH. Cardiac veins: a review of the literature. Clin Anat 2009; 22: 129–145.Google Scholar
Ho, SY, Sanchez-Quintana, D, Becker, AE. A review of the coronary venous system: a road less travelled. Heart Rhythm 2004; 1: 107–112.Google Scholar
Zhou, P, Pu, WT. Recounting cardiac cellular composition. Circ Res 2016; 118: 368–370.Google Scholar
Pinto, AR, Ilinykh, A, Ivey, MJ et al. Revisiting cardiac cellular composition. Circ Res 2016; 118: 400–409.Google Scholar
Anderson, RH, Smerup, M, Sanchez-Quintana, D, Loukas, M, Lunkenheimer, PP. The three-dimensional arrangement of myocytes in the ventricular walls. Clin Anat 2009; 22: 64–76.Google Scholar
Stephens, WE, Zuccollo, JM. Anitschkow myocytes or cardiac histiocytes in human hearts. Pathology 1999; 31: 98–101.Google Scholar
Favara, BE, Moores, H. Anitschkow nuclear structure: a study of pediatric hearts. Pediatr Pathol 1987; 7: 151–164.Google Scholar
Goyal, VK. Early appearance and rate of lipofuscin pigment accumulation in human myocardium. Exp Geront 1981; 16: 219–222.Google Scholar
Douglas, YL, Jongbloed, MR, Gittenberger-de, Groot AC et al. Histology of vascular myocardial wall of left atrial body after pulmonary venous incorporation. Am J Cardiol 2006; 97: 662–670.Google Scholar
Smith, EB, Butcher, J. The incidence, distribution and significance of megakaryocytes in normal and diseased human tissues. Blood 1952; 7: 214–224.Google Scholar
Levick, SP, Meléndez, GC, Plante, E et al. Cardiac mast cells: the centrepiece in adverse myocardial remodelling. Cardiovasc Res 2011; 89(1): 2–19.Google Scholar
Acebo, E, Val-Bernal, JF, Gómez-Román, JJ. Prichard’s structures of the fossa ovalis are not histogenetically related to cardiac myxoma. Histopathology 2001; 39: 529–535.Google Scholar
Val-Bernal, JF, Martino, M, Mayorga, M, Garijo, MF. Prichard’s structures of the fossa ovalis are age-related phenomena composed of nonreplicating endothelial cells: the cardiac equivalent of cutaneous senile angioma. APMIS 2007; 115: 1234–1240.Google Scholar
Hinton, RB, Yutzey, KE. Heart valve structure in development and disease. Annu Rev Physiol 2011; 73: 29–46.Google Scholar
Mirzaie, M, Schultz, M, Schwartz, P, Coulibaly, M, Schöndube, F. Evidence of woven bone formation in heart valve disease. Ann Thorac Cardiovasc Surg 2003; 9: 163–169.Google Scholar
Zimmerman, KG, Paplanus, SH, Dong, S, Nagle, RB. Congenital blood cysts of the heart valves. Hum Pathol 1983; 14: 699–703.Google Scholar
Gallucci, V, Stritoni, P, Fasoli, G, Thiene, G. Giant blood cyst of tricuspid valve. Successful excision in an infant. Br Heart J 1976; 38: 990–992.Google Scholar
Cook, AC, Fagg, NLK, Sharland, GK. Large blood cyst causing severe left ventricular obstruction in a fetus. Cardiol Young 1996; 6: 171–173.Google Scholar
Anderson, KR, Ho, SY, Anderson, RH. Location and vascular supply of sinus node in human heart. Br Heart J 1979; 41: 28–32.Google Scholar
Pesonen, E. Extrinsic and intrinsic factors relating to intimal thickening in children. Acta Paediatr Suppl 2004; 446: 43–47.Google Scholar
DeSa, DJ. Coronary artery ruptures in stillbirths Pediatr Dev Pathol 2002; 5: 605.Google Scholar
Loukas, M, Abel, M, Tubbs, RS et al. The cardiac lymphatic system. Clin Anat 2011; 24: 684–691.Google Scholar
Sommer, JR, Waugh, RA. Ultrastructure of heart muscle. Environ Health Perspect 1978; 26: 159–167.CrossRefGoogle ScholarPubMed
Chiba, A, Watanabe-Takano, H, Miyazaki, T, Mochizuki, N. Cardiomyokines from the heart. Cell Mol Life Sci 2018; 75: 1349–1362.Google Scholar
Hoppel, CL, Tandler, B, Fujioka, H, Riva, A. Dynamic organization of mitochondria in human heart and in myocardial disease. Int J Biochem Cell Biol 2009; 41: 1949–1956.Google Scholar
Severs, NJ, Bruce, AF, Dupont, E, Rothery, S. Remodelling of gap junctions and connexin expression in diseased myocardium. Cardiovasc Res 2008; 80: 9–19.Google Scholar
Desplantez, T. Cardiac Cx43, Cx40 and Cx45 co-assembling: involvement of connexins epitopes in formation of hemichannels and Gap junction channels. BMC Cell Biol 2017; 18: 3.CrossRefGoogle ScholarPubMed
Schulz, DM, Giordano, DA, Schulz, DH. Weights of organs of fetuses and infants. Arch Pathol 1962; 74: 244–250.Google Scholar
Rowlatt, UF, Rimoldi, HJA, Lev, M. The quantitative anatomy of the normal child’s heart. Pediatr Clin N Am 1963; 10: 499–588.Google Scholar
Eckner, FAO, Brown, BW, Davidson, DL, Glagov, S. Dimensions of normal human hearts. Arch Pathol Lab Med 1969; 88: 497–507.Google Scholar
Sholtz, DG, Kitzman, DW, Hagen, PT, Ilstrup, DM, Edwards, WD. Age related changes in normal human hearts during the first 10 decades of life. Part I (growth): a quantitative anatomic study of 200 specimens from subjects from birth to 19 years old. Mayo Clin Proc 1988; 63: 126.Google Scholar
Alvarez, L, Aránega, A, Saucedo, R, Contreras, JA. The quantitative anatomy of the normal human heart in fetal and perinatal life. Int J Cardiol 1987; 17: 57–72.Google Scholar
Hanson, K, Sung, CJ, Huang, C et al. Reference values for second trimester fetal and neonatal organ weights and measurements. Ped Devel Pathol 2003; 6:160–167.Google Scholar
Guihard-Costa, AM, Ménez, F, Delezoide, AL. Organ weights in human fetuses after formalin fixation: standards by gestational age and body weight. Pediatr Dev Pathol 2002; 5: 559–578.Google Scholar
Pryce, JW, Bamber, AR, Ashworth, MT et al. Reference ranges for organ weights of infants at autopsy: results of >1,000 consecutive cases from a single centre. BMC Clin Pathol 2014; 14: 18.Google Scholar
Gaitskell, K, Perera, R, Soilleux, EJ. Derivation of new reference tables for human heart weights in light of increasing body mass index. J Clin Pathol 2011; 64: 358–362.Google Scholar
Hees, PS, Fleg, JL, Lakatta, EG, Shapiro, EP. Left ventricular remodeling with age in normal men versus women: novel insights using three-dimensional magnetic resonance imaging. Am J Cardiol 2002; 90: 1231–1236.Google Scholar
Okuma, H, Gonoi, W, Ishida, M et al. Heart wall is thicker on postmortem computed tomography than on antemortem [corrected] computed tomography: the first longitudinal study. PLoS ONE 2013; 8: e76026.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×