The heart is a muscular organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make up the circulatory system. The pumped blood carries oxygen and nutrients to the tissue, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest, called the mediastinum.
| Heart | |
|---|---|
An illustration of the anterior view of the human heart | |
| Details | |
| System | Circulatory |
| Artery | Aorta, pulmonary trunk and right and left pulmonary arteries, right coronary artery, left main coronary artery |
| Vein | Superior vena cava, inferior vena cava, right and left pulmonary veins, great cardiac vein, middle cardiac vein, small cardiac vein, anterior cardiac veins |
| Nerve | Accelerans nerve, vagus nerve |
| Identifiers | |
| Latin | cor |
| Greek | καρδία (kardía) |
| MeSH | D006321 |
| Anatomical terminology [edit on Wikidata] | |
In humans, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles. Commonly, the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. In a healthy heart, blood flows one way through the heart due to heart valves, which prevent backflow. The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall of the heart is made up of three layers: epicardium, myocardium, and endocardium.
The heart pumps blood with a rhythm determined by a group of pacemaker cells in the sinoatrial node. These generate an electric current that causes the heart to contract, traveling through the atrioventricular node and along the conduction system of the heart. In humans, deoxygenated blood enters the heart through the right atrium from the superior and inferior venae cavae and passes to the right ventricle. From here, it is pumped into pulmonary circulation to the lungs, where it receives oxygen and gives off carbon dioxide. Oxygenated blood then returns to the left atrium, passes through the left ventricle and is pumped out through the aorta into systemic circulation, traveling through arteries, arterioles, and capillaries—where nutrients and other substances are exchanged between blood vessels and cells, losing oxygen and gaining carbon dioxide—before being returned to the heart through venules and veins. The adult heart beats at a resting rate close to 72 beats per minute.
Cardiovascular diseases were the most common cause of death globally as of 2008, accounting for 30% of all human deaths. Of these more than three-quarters are a result of coronary artery disease and stroke. Risk factors include: smoking, being overweight, little exercise, high cholesterol, high blood pressure, and poorly controlled diabetes, among others. Cardiovascular diseases do not frequently have symptoms but may cause chest pain or shortness of breath. Diagnosis of heart disease is often done by the taking of a medical history, listening to the heart-sounds with a stethoscope, as well as with ECG, and echocardiogram which uses ultrasound. Specialists who focus on diseases of the heart are called cardiologists, although many specialties of medicine may be involved in treatment.
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Structure
Location and shape
The human heart is situated in the mediastinum, at the level of thoracic vertebrae T5–T8. A double-membraned sac called the pericardium surrounds the heart and attaches to the mediastinum. The back surface of the heart lies near the vertebral column, and the front surface, known as the sternocostal surface, sits behind the sternum and rib cartilages. The upper part of the heart is the attachment point for several large blood vessels—the venae cavae, aorta and pulmonary trunk. The upper part of the heart is located at the level of the third costal cartilage. The lower tip of the heart, the apex, lies to the left of the sternum (8 to 9 cm from the midsternal line) between the junction of the fourth and fifth ribs near their articulation with the costal cartilages.
The largest part of the heart is usually slightly offset to the left side of the chest (levocardia). In a rare congenital disorder (dextrocardia) the heart is offset to the right side and is felt to be on the left because the left heart is stronger and larger, since it pumps to all body parts. Because the heart is between the lungs, the left lung is smaller than the right lung and has a cardiac notch in its border to accommodate the heart. The heart is cone-shaped, with its base positioned upwards and tapering down to the apex. An adult heart has a mass of 250–350 grams (9–12 oz). The heart is often described as the size of a fist: 12 cm (5 in) in length, 8 cm (3.5 in) wide, and 6 cm (2.5 in) in thickness, although this description is disputed, as the heart is likely to be slightly larger. Well-trained athletes can have much larger hearts due to the effects of exercise on the heart muscle, similar to the response of skeletal muscle.
Chambers
The heart has four chambers, two upper atria, the receiving chambers, and two lower ventricles, the discharging chambers. The atria open into the ventricles via the atrioventricular valves, present in the atrioventricular septum. This distinction is visible also on the surface of the heart as the coronary sulcus. There is an ear-shaped structure in the upper right atrium called the right atrial appendage, or auricle, and another in the upper left atrium, the left atrial appendage. The right atrium and the right ventricle together are sometimes referred to as the right heart. Similarly, the left atrium and the left ventricle together are sometimes referred to as the left heart. The ventricles are separated from each other by the interventricular septum, visible on the surface of the heart as the anterior longitudinal sulcus and the posterior interventricular sulcus.
The fibrous cardiac skeleton gives structure to the heart. It forms the atrioventricular septum, which separates the atria from the ventricles, and the fibrous rings, which serve as bases for the four heart valves. The cardiac skeleton also provides an important boundary in the heart's electrical conduction system since collagen cannot conduct electricity. The interatrial septum separates the atria, and the interventricular septum separates the ventricles. The interventricular septum is much thicker than the interatrial septum since the ventricles need to generate greater pressure when they contract.
Valves
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