DEVELOPMENT OF HEART

Cardiovascular system: Appears in the 3rd week of intrauterine life It is the first system to start functioning when embryo is no longer able to satisfy its nutritional requirements by diffusion. Development of heart Cardiogenic area- Cranial to prochordal plate From splanchnopleuric mesoderm Starts around 18th day of intrauterine life Blood islands unite and form cardiac tubes Intraembryonic cavity over it is pericardial cavity.

Blood Islands Cardiogenic area

Pericardial cavity

Two endocardial heart tubes single primitive heart tube

Bilateral cardiogenic cords canalized to form the paired endocardial heart tubes 2 endocardial heart tubes fuse to form a single tube- called primitive heart tube This fusion starts cranially & extends in caudal direction. The endocardial heart tube forms the endothelial lining or endocardium of the heart Splanchnopleuric mesoderm covering the heart tube forms myoepicardial mantle which gives rise to cardiac muscles and visceral layer of the pericardium (epicardium)

Parts of endocardial heart tube Initially the heart tube shows a series of dilatations & constrictions resulting in 4 chambers. From cranial to caudal end 1. Truncus arterious Bulbus cordis 2. Conus 3. Primitive ventricle 4. Primitive atrium 5. Sinus venosus
Umbilical vein Aortic sac

1 2 3 4 5
Vitelline vein Common cardinal vein

Fusion of heart tubes

nd (22

day)

THE HEART TUBE

The ventricle and the atrium are connected by a narrow atrioventricular canal The sinus venosus has right and left horns The bulbus cordis lies at the arterial end of the heart and is divisible into a proximal conus and a distal truncus arteriosus The sinus venosus lies at the venous end of the heart tube

THE HEART TUBE

The truncus arteriosus is continuous distally with the aortic sac which is connected to the dorsal aortae by the pharyngeal arch arteries Each horn of the sinus venosus receives one vitelline vein, one umbilical vein and one common cardinal vein As a result of rapid growth of the tube it becomes folded on itself to form a U shaped bulboventricular loop The atria and the sinus venosus now come to lie above and behind the ventricle

Formation of bulboventricular loop

Diagramatic representation of incorporation of conus into ventricle

Sinus venosus Represent the venous end of the heart tube Has a body and right and left horns Each horn receives 3 veins Vitelline vein-from the yolk sac Umbilical vein-from placenta Common cardinal vein- from the body wall of the embryo
Umbilical vein Common cardinal vein Aortic sac

sinus venosus
Vitelline vein

Fate of sinus venosus Left horn Receives less blood Retrogresses Becomes a tributary of right horn Left horn- develops into coronary sinus Right horn Receives more blood
Umbilical vein
sinus venosus

Aortic sac

Common cardinal vein

Vitelline vein

Incorporated into primitive atrium & forms smooth part of right atrium Right common cardinal vein- superior vena cava Right vitelline vein- part of inferior vena cava

Fate of primitive atrium After absorption of the sinus venosus, the atrial chamber is partitioned to form the right and left atria by the development of inter-atrial septum Inter atrial septum- Septum primum and septum secundum Till birth there is gap between 2 septa- foramen ovale Only after birth the 2 septa fuse to complete the partition Right half- Rough part of right atrium Left half- Rough part of left atrium (auricle)

Fate of primitive ventricle and bulbus cordis Conus part of bulbus cordis is absorbed into the primitive ventricle to form a bulbo-ventricular chamber Bulbo-ventricular chamber is later divided into 2 by the development of interventricular septum to give rise to the right and left ventricles. Inter ventricular septumPrimitive inter-ventricular septum Atrio-ventricular cushion Spiral septum

Right half of conus- Smooth part of right ventricle Right half of primitive ventricle- rough part of right ventricle Left half of conus- Smooth part of left ventricle Left half of primitive ventricle- rough part of left ventricle Truncus arterious- Partitioned by spiral septum to form the ascending aorta and pulmonary trunk.

Summary of development of the heart

Right atrium Rough partPrimitive atrium

Sinus venarum (smooth part)- Absorption of right horn of sinus venosus Interatrial septum- Septum primum & Septum secundum Left atrium Rough part- Primitive atrium Smooth part- Absorption of pulmonary veins Interatrial septum- Septum primum & Septum secundum

Summary of development of the heart

Right ventricle Inflowing part- Right part of primitive ventricle Outflowing part- Right part of conus Left ventricle Inflowing part- Left part of primitive ventricle Outflowing part- Left part of conus Development of other associated structuresCoronary sinus- Left horn of sinus venosus & Left common cardinal vein Oblique vein of Marshall- Left common cardinal vein Inferior vena cava- Terminal part of right vitelline vein Superior vena cava- Right anterior cardinal vein & Right common cardinal vein

Development of serous pericardium

Parietal layer- Somatopleuric layer of lateral plate mesoderm Visceral layer- Splanchnopleuric layer of lateral plate mesoderm Transverse pericardial sinusThe heart tube is for some time suspended from the dorsal wall of the pericardial cavity by two layers of pericardium called dorsal mesocardium The disappearance of dorsal mesocardium results in transverse sinus Oblique pericardial sinusBy the rearrangements of pulmonary veins

Summary
Splanchnopleuric mesoderm angiogenic cell clusters Cardiogenic area & dorsal aortae Cardiogenic area primitive endocardial tubes Single heart tube Dilatations -

Fusion of the heart tubes

1. 2. 3. 4. 5. Sinus venosus Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atrium

6. Cardinal veins

Atrial and ventricular septum

1. Septum primum 2. Septum secundum 3. Pulmonary veins 4. Ostium secundum 5. Foramen ovale 6. Membranous interventricular septum 7. Muscular interventricular septum 8. Endocardial cushions

Atrial and ventricular septum

1. Venous valves 2. Septum primum 3. Ostium secundum 4. Septum secundum 5. Pulmonary veins 6. Endocardial cushions 7. Interventricular foramen 8. Muscular interventricular septum 9. Foramen ovale

Formation of aorticopulmonary septum

1. Aorta 2. Left pulmonary artery 3. Pulmonary trunk 4. Muscular interventricular septum 5. Right ventricle 6. Membranous interventricular septum

Development of aorticopulmonary septum

1. Aorticopulmonary septum 2. Pulmonary valve 3. Pulmonary artery 4. Aortic valve 5. Aorta

Formation of the atria

1. Superior vena cava 2. Pulmonary veins 3. Left atrium 4. Right atrium 5. Septum primum 6. Septum secundum 7. Primitive left atrium 8. Primitive right atrium 9. Valve of inferior vena cava 10. Valve of coronary sinus 11. Sinus venarum

Formation of the ventricles

1. Membranous interventricular septum 2. Muscular interventricular septum 3. Endocardial cushions 4. Left ventricle 5. Right ventricle 6. Ventricular wall

Partitioning of the atrioventricular canal

1. Lateral endocardial cushion 2. Ventral endocardial cushion 3. Dorsal endocardial cushion 4. Left atrioventricular canal 5. Right atrioventricular canal

1. Left atrioventricular canal 2. Right atrioventricular canal 3. Tricuspid valves 4. Bicuspid valves

Anomalies
Dextrocardia- Anomolies of cardiac looping Heart lies on the right side of the thorax instead of left. Situs inversus, a complete reversal of asymmetry in all organs Atrial septal defect (ASD) or Patent foramen ovale or ostium secundum defect A large opening between the left and right atrium.

Anomalies

Ventricular septal defect (VSD) Ventricular septal defects more common Fallots tetralogy: Due to an unequal division of the conus Has 4 characteristic features 1. Pulmonary stenosis 2. Ventricular septal defect 3. Overriding of aorta 4. Hypertrophy of right ventricle

VSD

Persistent truncus arteriosus

Pulmonary artery orginates from common truncus A Failed septum formation in the truncus and conus B accompanied by VSD

Transposition of great vessels & pulmonary valvular atresia

Aortic valvular stenosis & atresia

END OF PART - I