Great cardiac vein

At a glance

English

Great cardiac vein

Latin (TA2)

Vena magna cordis

System

Vein

Region

Trunk

Side

Single, on the midline

About the great cardiac vein

The great cardiac vein is the main vein on the front of the heart. It starts near the apex and rises in the anterior interventricular groove, the shallow furrow between the right and left ventricles, running beside the anterior interventricular branch of the left coronary artery. On reaching the ventricular base it turns to the left and follows the coronary groove between the left atrium and left ventricle, now alongside the circumflex artery, around the left border of the heart and onto its posterior surface. It is sometimes called the left coronary vein.

On the back of the heart it receives the small oblique atrial vein, and from that point onwards the channel is called the coronary sinus. The boundary is often marked by a small valve, the valve of Vieussens, and a slight narrowing. In effect the two are one continuous vessel, with the sinus being its widened terminal part that empties into the right atrium.

Along its course the vein collects blood from both ventricles and the left atrium, including much of the interventricular septum and the front of both ventricles. Its largest tributary is the left marginal vein, a sizable vessel that climbs the heart's left border and joins it as it rounds that border.

The vein matters in cardiology because it is reached from the coronary sinus. Electrophysiologists can pass catheters into it to record or treat rhythm disturbances arising near the left side of the heart, and its branches, especially the lateral and marginal veins, are used to place left-ventricular pacing leads. Its close course beside the left anterior descending artery also makes it a guide for surgeons operating on the front of the heart.

Course and drainage

Begins at

Starts close to the cardiac apex and climbs in the anterior interventricular groove.

Drains into

Curves left in the coronary groove onto the back of the heart and becomes the coronary sinus at the entry of the oblique atrial vein.

Drains

Drains the anterior parts of both ventricles, the interventricular septum and the left atrium, mainly through the left marginal vein and smaller ventricular veins.