A report on 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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Vascular ischemia of the toes with characteristic cyanosis

Ischemia

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Restriction in blood supply to any tissues, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism .

Restriction in blood supply to any tissues, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism .

Vascular ischemia of the toes with characteristic cyanosis
Native records of contractile activity of the left ventricle of isolated rat heart perfused under Langendorff technique. Curve A - contractile function of the heart is greatly depressed after ischemia-reperfusion. Curve B - a set of short ischemic episodes (ischemic preconditioning) before prolonged ischemia provides functional recovery of contractile activity of the heart at reperfusion.

It occurs when the heart muscle, or myocardium, receives insufficient blood flow.

Illustration depicting atherosclerosis in a coronary artery

Coronary artery disease

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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
Disability-adjusted life year for ischaemic heart disease per 100,000 inhabitants in 2004. 
no data
<350
350–700
700–1,050
1,050–1,400
1,400–1,750
1,750–2,100
2,100–2,450
2,450–2,800
2,800–3,150
3,150–3,500
3,500–4,000
>4,000

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.

Coronary arteries labeled in red text and other landmarks in blue text.

Coronary circulation

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Coronary arteries labeled in red text and other landmarks in blue text.
Schematic diagram of the coronary arteries and veins.
Schematic view of the heart
An anterior left coronary artery.
Base and diaphragmatic surface of heart.
Anterior view of coronary circulation
Posterior view of coronary circulation
Illustration of coronary arteries
The human heart viewed from the front and from behind

Coronary circulation is the circulation of blood in the blood vessels that supply the heart muscle (myocardium).

Heart; conduction system. 1. SA node. 2. AV node. 3. Bundle of His. 8. Septum

Electrical conduction system of the heart

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Heart; conduction system. 1. SA node. 2. AV node. 3. Bundle of His. 8. Septum
Overview of the system of electrical conduction which maintains the rhythmical contraction of the heart
Principle of ECG formation. Note that the red lines represent the depolarization wave, not bloodflow.
Different wave shapes generated by different parts of the heart's action potential

The electrical conduction system of the heart transmits signals generated usually by the sinoatrial node in the heart to cause contraction of the heart muscle.

Cardiac muscle, an intercalated disc can be seen joining cardiomyocytes in magnified section

Intercalated disc

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Cardiac muscle, an intercalated disc can be seen joining cardiomyocytes in magnified section
Ruptured intercalated discs, in this case regarded as a visual artifact.
Square-shaped nuclei, indicating forceful myocardial contraction.

Intercalated discs or lines of Eberth are microscopic identifying features of cardiac muscle.

400px

Troponin

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400px
Troponin activation. Troponin C (red) binds Ca2+, which stabilizes the activated state, where troponin I (yellow) is no longer bound to actin. Troponin T (blue) anchors the complex on tropomyosin.

Troponin, or the troponin complex, is a complex of three regulatory proteins (troponin C, troponin I, and troponin T) that are integral to muscle contraction in skeletal muscle and cardiac muscle, but not smooth muscle.

Interior of right side of heart

Endocardium

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Innermost layer of tissue that lines the chambers of the heart.

Innermost layer of tissue that lines the chambers of the heart.

Interior of right side of heart
Illustration depicting the layers of the heart wall including the innermost endocardium
Histology of the endocardium and subendocardium.

The endocardium underlies the much more voluminous myocardium, the muscular tissue responsible for the contraction of the heart.

Syncytium caused by HSV-1 infection in Vero cells

Syncytium

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Multinucleate cell which can result from multiple cell fusions of uninuclear cells (i.e., cells with a single nucleus), in contrast to a coenocyte, which can result from multiple nuclear divisions without accompanying cytokinesis.

Multinucleate cell which can result from multiple cell fusions of uninuclear cells (i.e., cells with a single nucleus), in contrast to a coenocyte, which can result from multiple nuclear divisions without accompanying cytokinesis.

Syncytium caused by HSV-1 infection in Vero cells

The term may also refer to cells interconnected by specialized membranes with gap junctions, as seen in the heart muscle cells and certain smooth muscle cells, which are synchronized electrically in an action potential.

The progression of atherosclerosis (narrowing exaggerated)

Atherosclerosis

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Pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions.

Pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions.

The progression of atherosclerosis (narrowing exaggerated)
Atherosclerosis and lipoproteins
Micrograph of an artery that supplies the heart showing significant atherosclerosis and marked luminal narrowing. Tissue has been stained using Masson's trichrome.
Severe atherosclerosis of the aorta. Autopsy specimen.
Progression of atherosclerosis to late complications.
CT image of atherosclerosis of the abdominal aorta. Woman of 70 years old with hypertension and dyslipidemia.
Microphotography of arterial wall with calcified (violet color) atherosclerotic plaque (hematoxylin and eosin stain)
Doppler ultrasound of right internal carotid artery with calcified and non-calcified plaques showing less than 70% stenosis

One recent hypothesis suggests that, for unknown reasons, leukocytes, such as monocytes or basophils, begin to attack the endothelium of the artery lumen in cardiac muscle.

Early in a coronary artery bypass operation, during vein harvesting from the legs (left of image) and the establishment of cardiopulmonary bypass by placement of an aortic cannula (bottom of image). The perfusionist and heart-lung machine are on the upper right. The patient's head (not seen) is at the bottom.

Coronary artery bypass surgery

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Surgical procedure to restore normal blood flow to an obstructed coronary artery.

Surgical procedure to restore normal blood flow to an obstructed coronary artery.

Early in a coronary artery bypass operation, during vein harvesting from the legs (left of image) and the establishment of cardiopulmonary bypass by placement of an aortic cannula (bottom of image). The perfusionist and heart-lung machine are on the upper right. The patient's head (not seen) is at the bottom.
René Gerónimo Favaloro was an Argentine cardiac surgeon and educator best known for his pioneering work on coronary artery bypass surgery using the great saphenous vein.
Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery system and one to the obtuse marginal system.
Illustration depicting single, double, triple, and quadruple bypass
Illustration of a typical coronary artery bypass surgery. A vein from the leg is removed and grafted to the coronary artery to bypass a blockage.
Coronary artery bypass surgery during mobilization (freeing) of the right coronary artery from its surrounding tissue, adipose tissue (yellow). The tube visible at the bottom is the aortic cannula (returns blood from the HLM). The tube above it (obscured by the surgeon on the right) is the venous cannula (receives blood from the body). The patient's heart is stopped and the aorta is cross-clamped. The patient's head (not seen) is at the bottom.
Heart bypass patient showing almost invisible residual scarring. Left: days after operation. Middle: chest scar, two years later. Right: leg scar from harvested vein, two years later.
Illustration depicting coronary artery bypass surgery (double bypass)
Illustration of Single bypass
Illustration of Double bypass
Illustration of Triple bypass
Illustration of Quadruple bypass

A normal coronary artery transports blood to the heart muscle itself, not through the main circulatory system.