Cardiac muscle

3D rendering showing thick myocardium within the heart wall.
The swirling musculature of the heart ensures effective pumping of blood.
Cardiac muscle
Illustration of a cardiac muscle cell.
Intercalated discs are part of the cardiac muscle cell sarcolemma and they contain gap junctions and desmosomes.
Dog cardiac muscle (400X)

One of three types of vertebrate muscle tissue, with the other two being skeletal muscle and smooth muscle.

- Cardiac muscle

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Heart

Muscular organ in most animals that pumps blood through the blood vessels of the circulatory system.

Muscular organ in most animals that pumps blood through the blood vessels of the circulatory system.

Human heart during an autopsy
Computer-generated animation of a beating human heart
The human heart is in the middle of the thorax, with its apex pointing to the left.
Heart being dissected showing right and left ventricles, from above
Frontal section showing papillary muscles attached to the tricuspid valve on the right and to the mitral valve on the left via chordae tendineae.
Layers of the heart wall, including visceral and parietal pericardium
The swirling pattern of myocardium helps the heart pump effectively
Arterial supply to the heart (red), with other areas labelled (blue).
Autonomic innervation of the heart
Development of the human heart during the first eight weeks (top) and the formation of the heart chambers (bottom). In this figure, the blue and red colors represent blood inflow and outflow (not venous and arterial blood). Initially, all venous blood flows from the tail/atria to the ventricles/head, a very different pattern from that of an adult.
Blood flow through the valves
The cardiac cycle as correlated to the ECG
The x-axis reflects time with a recording of the heart sounds. The y-axis represents pressure.
Transmission of a cardiac action potential through the heart's conduction system
Conduction system of the heart
The prepotential is due to a slow influx of sodium ions until the threshold is reached followed by a rapid depolarization and repolarization. The prepotential accounts for the membrane reaching threshold and initiates the spontaneous depolarization and contraction of the cell; there is no resting potential.
3D echocardiogram showing the mitral valve (right), tricuspid and mitral valves (top left) and aortic valve (top right).
The closure of the heart valves causes the heart sounds.
Cardiac cycle shown against ECG
Heart and its blood vessels, by Leonardo da Vinci, 15th century
Animated heart
Elize Ryd making a heart sign at a concert in 2018
The tube-like heart (green) of the mosquito Anopheles gambiae extends horizontally across the body, interlinked with the diamond-shaped wing muscles (also green) and surrounded by pericardial cells (red). Blue depicts cell nuclei.
Basic arthropod body structure – heart shown in red
The human heart viewed from the front
The human heart viewed from behind
The coronary circulation
The human heart viewed from the front and from behind
Frontal section of the human heart
An anatomical specimen of the heart
Heart illustration with circulatory system
Animated Heart 3d Model Rendered in Computer

The wall of the heart is made up of three layers: epicardium, myocardium, and endocardium.

Types of muscle contractions

Muscle contraction

Activation of tension-generating sites within muscle cells.

Activation of tension-generating sites within muscle cells.

Types of muscle contractions
In vertebrate animals, there are three types of muscle tissues: 1) skeletal, 2) smooth, and 3) cardiac
Organization of skeletal muscle
Structure of neuromuscular junction.
Sliding filament theory: A sarcomere in relaxed (above) and contracted (below) positions
Cross-bridge cycle
Muscle length versus isometric force
Force–velocity relationship: right of the vertical axis concentric contractions (the muscle is shortening), left of the axis eccentric contractions (the muscle is lengthened under load); power developed by the muscle in red. Since power is equal to force times velocity, the muscle generates no power at either isometric force (due to zero velocity) or maximal velocity (due to zero force). The optimal shortening velocity for power generation is approximately one-third of maximum shortening velocity.
Swellings called varicosities belonging to an autonomic neuron innervate the smooth muscle cells.
Cardiac muscle
Key proteins involved in cardiac calcium cycling and excitation-contraction coupling
A simplified image showing earthworm movement via peristalsis
Asynchronous muscles power flight in most insect species. a: Wings b: Wing joint c: Dorsoventral muscles power the upstroke d: Dorsolongitudinal muscles (DLM) power the downstroke. The DLMs are oriented out of the page.
Electrodes touch a frog, and the legs twitch into the upward position

Unlike skeletal muscle, the contractions of smooth and cardiac muscles are myogenic (meaning that they are initiated by the smooth or heart muscle cells themselves instead of being stimulated by an outside event such as nerve stimulation), although they can be modulated by stimuli from the autonomic nervous system.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.

Heart failure

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body; its signs and symptoms result from a structural and/or functional abnormality of the heart, that disrupts its filling with blood or its ejecting of it during each heart beat.

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body; its signs and symptoms result from a structural and/or functional abnormality of the heart, that disrupts its filling with blood or its ejecting of it during each heart beat.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.
Signs and symptoms of severe heart failure
Severe peripheral pitting edema
Kerley B lines in acute cardiac decompensation. The short, horizontal lines can be found everywhere in the right lung.
Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of left ventricle (right); both during diastole
Chest radiograph of a lung with distinct Kerley B lines, as well as an enlarged heart (as shown by an increased cardiothoracic ratio, cephalization of pulmonary veins, and minor pleural effusion as seen for example in the right horizontal fissure. Yet, no obvious lung edema is seen. Overall, this indicates intermediate severity (stage II) heart failure.
Siderophages (one indicated by white arrow) and pulmonary congestion, indicating left congestive heart failure
Ultrasound showing severe systolic heart failure
Congestive heart failure with small bilateral effusions
Kerley B lines

Heart failure may be the result of coronary artery disease, and its prognosis depends in part on the ability of the coronary arteries to supply blood to the myocardium (heart muscle).

A top-down view of skeletal muscle

Skeletal muscle

Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system that are mostly attached by tendons to bones of the skeleton.

Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system that are mostly attached by tendons to bones of the skeleton.

A top-down view of skeletal muscle
3D rendering of a skeletal muscle fiber
Muscle types by fiber arrangement
Types of pennate muscle. A – unipennate; B – bipennate; 
C – multipennate
ATPase staining of a muscle cross section. Type II fibers are dark, due to the alkaline pH of the preparation. In this example, the size of the type II fibers is considerably less than the type I fibers due to denervation atrophy.
Structure of muscle fibre showing a sarcomere under electron microscope with schematic explanation.
Diagram of sarcoplasmic reticulum with terminal cisternae and T-tubules.
Human embryo showing somites labelled as primitive segments.
When a sarcomere contracts, the Z lines move closer together, and the I band becomes smaller. The A band stays the same width. At full contraction, the thin and thick filaments overlap.
Contraction in more detail
(a) Some ATP is stored in a resting muscle. As contraction starts, it is used up in seconds. More ATP is generated from creatine phosphate for about 15 seconds. (b) Each glucose molecule produces two ATP and two molecules of pyruvic acid, which can be used in aerobic respiration or converted to lactic acid. If oxygen is not available, pyruvic acid is converted to lactic acid, which may contribute to muscle fatigue. This occurs during strenuous exercise when high amounts of energy are needed but oxygen cannot be sufficiently delivered to muscle. (c) Aerobic respiration is the breakdown of glucose in the presence of oxygen (O2) to produce carbon dioxide, water, and ATP. Approximately 95 percent of the ATP required for resting or moderately active muscles is provided by aerobic respiration, which takes place in mitochondria.
Exercise-induced signaling pathways in skeletal muscle that determine specialized characteristics of slow- and fast-twitch muscle fibers
Jogging is one form of aerobic exercise.
In muscular dystrophy, the affected tissues become disorganized and the concentration of dystrophin (green) is greatly reduced.
Prisoner of war exhibiting muscle loss as a result of malnutrition.

The other types of muscle are cardiac muscle which is also striated and smooth muscle which is non-striated; both of these types of muscle tissue are classified as involuntary, or, under the control of the autonomic nervous system.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)

Arrhythmia

Too fast or too slow.

Too fast or too slow.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
Broad classification of arrhythmias according to region of heart required to sustain the rhythm
Normal sinus rhythm, with solid black arrows pointing to normal P waves representative of normal sinus node function, followed by a pause in sinus node activity (resulting in a transient loss of heartbeats). Note that the P wave that disrupts the pause (indicated by the dashed arrow) does not look like the previous (normal) P waves – this last P wave is arising from a different part of the atrium, representing an escape rhythm.

Automaticity refers to a cardiac muscle cell firing off an impulse on its own.

Illustration depicting atherosclerosis in a coronary artery

Coronary artery disease

Illustration depicting atherosclerosis in a coronary artery
Clogged artery
Micrograph of a coronary artery with the most common form of coronary artery disease (atherosclerosis) and marked luminal narrowing. Masson's trichrome.
Illustration depicting coronary artery disease
Coronary angiogram of a man
Coronary angiogram of a woman
Deaths due to ischaemic heart disease per million persons in 2012

Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart.

General structure of a skeletal muscle cell and neuromuscular junction: 1. Axon

2. Neuromuscular junction

3. Skeletal muscle fiber

4. Myofibril

Muscle cell

General structure of a skeletal muscle cell and neuromuscular junction: 1. Axon

2. Neuromuscular junction

3. Skeletal muscle fiber

4. Myofibril
Diagram of skeletal muscle fiber structure

A muscle cell is also known as a myocyte when referring to either a cardiac muscle cell (cardiomyocyte), or a smooth muscle cell as these are both small cells.

Ribbon diagram of G-actin. ADP bound to actin's active site (multi color sticks near center of figure) as well as a complexed calcium dication (green sphere) are highlighted.

Actin

Family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils.

Family of globular multi-functional proteins that form microfilaments in the cytoskeleton, and the thin filaments in muscle fibrils.

Ribbon diagram of G-actin. ADP bound to actin's active site (multi color sticks near center of figure) as well as a complexed calcium dication (green sphere) are highlighted.
Fluorescence micrograph showing F-actin (in green) in rat fibroblasts
A merged stack of confocal images showing actin filaments within a cell. The image has been colour coded in the z axis to show in a 2D image which heights filaments can be found at within cells.
Structure of the C-terminal subdomain of villin, a protein capable of splitting microfilaments
The structure of a sarcomere, the basic morphological and functional unit of the skeletal muscles that contains actin
Diagram of a zonula occludens or tight junction, a structure that joins the epithelium of two cells. Actin is one of the anchoring elements shown in green.
Ribbon model of actin from rabbitmuscle. The four subdomains can be seen, as well as the N and C termini and the position of the ATP bond. The molecule is oriented using the usual convention of placing the - end (pointed end) up and the + end (barbed end) down.
F-actin; surface representation of a repetition of 13 subunits based on Ken Holmes' actin filament model
Ribbon model obtained using the PyMOL programme on crystallographs of the prefoldin proteins found in the archaean Pyrococcus horikoshii. The six supersecondary structures are present in a coiled helix “hanging” from the central beta barrels. These are often compared in the literature to the tentacles of a jellyfish. As far as is visible using electron microscopy, eukariotic prefoldin has a similar structure.
Ribbon model of the apical γ-domain of the chaperonin CCT
Microfilament formation showing the polymerization mechanism for converting G-actin to F-actin; note the hydrolysis of the ATP.
Atomic structure of Arp2/3. Each colour corresponds to a subunit: Arp3, orange; Arp2, sea blue (subunits 1 and 2 are not shown); p40, green; p34, light blue; p20, dark blue; p21, magenta; p16, yellow.
An actin (green) - profilin (blue) complex. The profilin shown belongs to group II, normally present in the kidneys and the brain.
The protein gelsolin, which is a key regulator in the assembly and disassembly of actin.
Principal interactions of structural proteins are at cadherin-based adherens junction. Actin filaments are linked to α-actinin and to the membrane through vinculin. The head domain of vinculin associates to E-cadherin via α-catenin, β-catenin, and γ-catenin. The tail domain of vinculin binds to membrane lipids and to actin filaments.
Structure of MreB, a bacterial protein whose three-dimensional structure resembles that of G-actin
Giant nemaline rods produced by the transfection of a DNA sequence of ACTA1, which is the carrier of a mutation responsible for nemaline myopathy
Position of seven mutations relevant to the various actinopathies related to ACTA1
Cross section of a rat heart that is showing signs of dilated cardiomyopathy
Image taken using confocal microscopy and employing the use of specific antibodies showing actin's cortical network. In the same way that in juvenile dystonia there is an interruption in the structures of the cytoskeleton, in this case it is produced by cytochalasin D.
Western blot for cytoplasmic actin from rat lung and epididymis
Nobel Prize winning physiologist Albert von Szent-Györgyi Nagyrápolt, co-discoverer of actin with Brunó Ferenc Straub
Chemical structure of phalloidin

Of these, two code for the cytoskeleton (ACTB and ACTG1) while the other four are involved in skeletal striated muscle (ACTA1), smooth muscle tissue (ACTA2), intestinal muscles (ACTG2) and cardiac muscle (ACTC1).

Illustration depicting angina

Angina

Illustration depicting angina
Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Can also feel discomfort in the neck, jaw, shoulders, back or arms.

Angina, also known as angina pectoris, is chest pain or pressure, a symptom of coronary heart disease, usually due to insufficient blood flow to the heart muscle (myocardium).