MRCEM Notes

Cardiac blood supply

There is variation amongst individuals in terms of which coronary artery supplies which territory as coronary artery dominance is variable but the college expect you to be aware of the 'typical' territories supplied.

As 70% of the population are right coronary dominant this means being familiar with a right dominant supply. The college only expect you to know the two principal branches of each artery which is summarised below. They also expect you to be familiar with the supply of the nodes.

Diagram illustrating coronary circulation


Right coronary artery
The right coronary artery supplies the right atrium and right ventricle as well as giving off branches to the nodes before dividing into its principal branches whose territories are summarised below
Main branchesterritory
Right marginal artery
  • Right ventricle and apex
Posterior interventricular artery
  • Interventricular septum (posterior 1/3)
  • Right and left ventricles

Key point
Both the AV and SA nodes are supplied by the right coronary artery branches

Left coronary artery
Main branchesterritory
Left anterior descending (LAD)
also known as anterior interventricular branch
  • Both ventricles
  • Interventricular septum (anterior 2/3)
Circumflex artery
  • Left ventricle
  • Left atrium
Full-size image