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Heart, in anatomy, hollow muscular organ that pumps

blood through the body. The heart, blood, and blood


vessels make up the circulatory system, which is
responsible for distributing oxygen and nutrients to the
body and carrying away carbon dioxide and other
waste products. The heart is the circulatory system’s
power supply. It must beat ceaselessly because the
body’s tissues especially the brain and the heart itself
depend on a constant supply of oxygen and nutrients
delivered by the flowing blood. If the heart stops
pumping blood for more than a few minutes, death will
Four valves within the heart prevent blood from flowing
backward in the heart. The valves open easily in the direction
of blood flow, but when blood pushes against the valves in
the opposite direction, the valves close. Two valves, known
as atrioventricular valves, are located between the atria and
ventricles. The right atrioventricular valve is formed from
three flaps of tissue and is called the tricuspid valve. The left
atrioventricular valve has two flaps and is called the bicuspid
or mitral valve. The other two heart valves are located
between the ventricles and arteries. They are called
semilunar valves because they each consist of three half-
moon-shaped flaps of tissue. The right semilunar valve,
between the right ventricle and pulmonary artery, is also
called the pulmonary valve. The left semilunar valve, between
the left ventricle and aorta, is also called the aortic valve.
Muscle tissue, known as myocardium or cardiac
muscle, wraps around a scaffolding of tough
connective tissue to form the walls of the heart’s
chambers. The atria, the receiving chambers of the
heart, have relatively thin walls compared to the
ventricles, the pumping chambers. The left ventricle
has the thickest walls—nearly 1 cm (0.5 in) thick in an
adult—because it must work the hardest to propel
blood to the farthest reaches of the body.
A tough, double-layered sac known as the pericardium
surrounds the heart. The inner layer of the pericardium,
known as the epicardium, rests directly on top of the
heart muscle. The outer layer of the pericardium
attaches to the breastbone and other structures in the
chest cavity and helps hold the heart in place. Between
the two layers of the pericardium is a thin space filled
with a watery fluid that helps prevent these layers from
rubbing against each other when the heart beats.
The inner surfaces of the heart’s chambers are lined with a thin
sheet of shiny, white tissue known as the endocardium. The same
type of tissue, more broadly referred to as endothelium, also lines
the body’s blood vessels, forming one continuous lining throughout
the circulatory system. This lining helps blood flow smoothly and
prevents blood clots from forming inside the circulatory system.
The heart is nourished not by the blood passing through its
chambers but by a specialized network of blood vessels.
Known as the coronary arteries, these blood vessels
encircle the heart like a crown. About 5 percent of the
blood pumped to the body enters the coronary arteries,
which branch from the aorta just above where it emerges
from the left ventricle. Three main coronary arteries—the
right, the left circumflex, and the left anterior descending—
nourish different regions of the heart muscle. From these
three arteries arise smaller branches that enter the
muscular walls of the heart to provide a constant supply of
oxygen and nutrients. Veins running through the heart
muscle converge to form a large channel called the
coronary sinus, which returns blood to the right atrium.
Unlike most muscles, which rely on nerve impulses to cause them to
contract, heart muscle can contract of its own accord. Certain heart muscle
cells have the ability to contract spontaneously, and these cells generate
electrical signals that spread to the rest of the heart and cause it to
contract with a regular, steady beat.

The heartbeat begins with a small group of specialized muscle cells


located in the upper right-hand corner of the right atrium. This area is
known as the sinoatrial (SA) node. Cells in the SA node generate their
electrical signals more frequently than cells elsewhere in the heart, so the
electrical signals generated by the SA node synchronize the electrical
signals traveling to the rest of the heart. For this reason, the SA node is
also known as the heart’s pacemaker.
Although the right and left halves of the heart are separate, they both
contract in unison, producing a single heartbeat. The sequence of events
from the beginning of one heartbeat to the beginning of the next is called
the cardiac cycle. The cardiac cycle has two phases: diastole, when the
heart’s chambers are relaxed, and systole, when the chambers contract to
move blood. During the systolic phase, the atria contract first, followed by
contraction of the ventricles. This sequential contraction ensures efficient
movement of blood from atria to ventricles and then into the arteries. If the
atria and ventricles contracted simultaneously, the heart would not be able
to move as much blood with each beat.
In an adult, resting heart rate is normally about 70 beats per minute.
However, the heart can beat up to three times faster—at more than 200
beats per minute—when a person is exercising vigorously. Younger
people have faster resting heart rates than adults do. The normal heart
rate is about 120 beats per minute in infants and about 100 beats per
minute in young children. Many athletes, by contrast, often have relatively
slow resting heart rates because physical training makes the heart
stronger and enables it to pump the same amount of blood with fewer
beats. An athlete’s resting heart rate may be only 40 to 60 beats per
minute.
To determine overall heart function, doctors measure cardiac output, the
amount of blood pumped by each ventricle in one minute. Cardiac output
is equal to the heart rate multiplied by the stroke volume, the amount of
blood pumped by a ventricle with each beat. Stroke volume, in turn,
depends on several factors: the rate at which blood returns to the heart
through the veins; how vigorously the heart contracts; and the pressure of
blood in the arteries, which affects how hard the heart must work to propel
blood into them. Normal cardiac output in an adult is about 3 liters per
minute per square meter of body surface.