Embryology of

Cardiovascular system 1

DR.NAVAJYOTHI,MBBS;MD
 INTRODUCTION
The vascular system appears in the middle of the
third week.
In the splanchnopleuric intraembryonic
mesoderm Cardiac progenitor cells are induced by
the underlying pharyngeal endoderm to form
cardiac myoblasts.
Blood islands appear in this mesoderm.
Vasculogenesis takes place and form blood cells
and vessels.
VASCULOGENESIS
 INTRODUCTION
The islands unite to form a horseshoe-shaped
endothelial-lined tube surrounded by myoblasts.
This region is known as the cardiogenic field.
The intraembryonic cavity over it later develops
into the pericardial cavity .
In addition to the cardiogenic region, other blood
islands appear bilaterally, parallel and close to the
midline of the embryonic shield.
These islands form a pair of longitudinal vessels,
the dorsal aortae.
Mesoderm surrounding the cardiogenic region
differentiates into myocardium.
 FORMATION OF HEART TUBE
As a result of growth of the brain and
cephalic folding of the embryo, the heart and
pericardial cavity move first to the cervical
region and finally to the thorax.
 FORMATION OF HEART TUBE
As the embryo folds laterally, the cardiac primordia
also folds laterally.
As a result, the caudal regions of the paired cardiac
primordia merge.
Thus, the heart becomes a continuous expanded
tube consisting of an inner endothelial lining and an
outer myocardial layer.
It receives venous drainage at its caudal pole and
begins to pump blood out of the first aortic arch into
the dorsal aorta at its cranial pole .
EMBRYONIC FOLDINGS
FUSION OF HEART TUBES
 DIVISION OF HEART TUBE
The heart tube shows series of dilatations,
these are:
Bulbus cordis
Primitive ventricle
Primitive atrium
Sinus venosus
The bulbus cordis again divides into unnamed
proximal1/3rd,middle conus cordis and distal
truncus arteriosus
PARTS OF HEART TUBE
 FORMATION OF HEART TUBE
The developing heart tube remains attached to the dorsal side of
the pericardial cavity by a fold of the dorsal mesocardium which
disappear later creating the transverse sinus, which connects
both sides of the pericardial cavity.
The heart is now suspended in the cavity by blood vessels at its
cranial and caudal poles.
The epicardium forms around the heart tissue.
Thus the heart tube consists of three layers:
(a) the endocardium, forming the internal
endothelial lining of the heart
(b) the myocardium, forming the muscular
Wall and
(c) the epicardium or visceral pericardium, covering the outside of
the tube.
This outer layer is responsible for formation of the coronary
arteries, including their endothelial lining and smooth muscle.
FORMATION OF TRANSVERSE SINUS
 FORMATION OF CARDIAC LOOP
The heart tube continues to elongate and bend on
23rd day.
The cephalic portion bends ventrally, caudally, and
to the right and the atrial (caudal) portion shifts
dorsocranially and to the left .
This bending creates the cardiac loop.
It is completed by day 28.
The bulboventricular loop fuses to form a common
chamber called the bulboventricular cavity
 FORMATION OF CARDIAC LOOP
The atrioventricular junction remains narrow to form
atrioventricular canal which connects the atrium and
ventricles.
The bulbous cordis proximal 1/3rd is narrow except at
its proximal end which forms the trabeculated part of
right ventricle.
The mid portion conus cordis forms the outflow tracts
of both ventricles.
The truncus arteriosus forms the root and proximal
portion of the aorta and pulmonar artery.
The primitive ventricle becomes the primitive left
ventricle.
FORMATION OF HEART TUBE
 FORMATION OF CARDIAC LOOP

V B D

A
V
SV
Chambers of primitive heart

A A

B-V Loop
V

Left view Front view

FATE OF HEART TUBE
Right atrium
 Development of sinus venosus
In the middle of the fourth week, the sinus venosus receives
venous blood
from the right and left sinus horns .
Each horn receives blood from three important veins: (a) the
vitelline or omphalomesenteric vein,
(b) the umbilical vein, and
(c) the common cardinal vein.
At first communication between the sinus and the atrium is
wide.
Soon, the entrance of the sinus shifts to the right
[ This shift is caused primarily by left-to-right shunts of blood,
which occur in the venous system during the fourth and fifth
weeks of development.
 Development of sinus venosus
Obliteration of the right umbilical vein and the left
vitelline vein during the fifth week.
When the left common cardinal vein is obliterated at
10 weeks, all that remains of the left sinus horn is
the oblique vein of the left atrium and the coronary
sinus .
As a result of left-to-right shunts of blood, the right
sinus horn and veins enlarge greatly.
Development of sinus venosus
Development of sinus venosus
 The right horn is incorporated into the right atrium to
form the smooth-walled part of the right atrium.
Its entrance, the sinuatrial orifice, has right and left
venous valves.
Dorsocranially the valves fuse, to form a ridge known
as the septum spurium.
The left venous valve fuse with the developing atrial
septum.
The superior portion of the right venous valve disappears
entirely.
 The inferior portion develops into two parts:

(a) the valve of inferior vena cava

(b) valve of coronary sinus

Septum spurium develops into the crista terminalis that

divides the smooth and trabecullated part of right atrium.
Development of sinus venosus
Ventral view of coronal sections through the heart at the level of the
atrioventricular canal to show development of the venous valves. A. 5 weeks.
(arrow).
C. Fetal stage. The sinus venarum (blue) is smooth walled; it derives from
the right sinus horn. Arrows, blood flow.
 Formation of the Cardiac Septa

The major septa of the heart are formed between the

27th and 37th days of development.

Formation of masses, endocardial cushions,

develop in the atrioventricular and conotruncal
regions.

They form the

- atrial and ventricular (membranous portion) septa,
-the atrioventricular canals and
- valves,
- and the aortic and pulmonary channels.
 ATRIOVENTRICULAR SEPTUM FORMATION

At the end of the fourth week, two mesenchymal

cushions, the atrioventricular endocardial cushions,
appear at the superior and inferior borders of the
atrioventricular canal .
These endocardial cushions grow towards each other
and finally fuse each other forming septum
intermedium
This result in the division of atrioventricular canal into
right and left halves.
Septum formation by two actively growing ridges that approach
each other until they fuse. C. Septum formed by a single actively growing cell mass.
D, E, and F. Septum formation by merging of two expanding portions of the wall of the
heart. Such a septum never completely separates two cavities.

Atrium
Bulboventricular cavity
Endocardial cushions
Atrioventricular canals
 Inter atrial Septum formation
At the end of the fourth week, a sickle-shaped crest
grows from the roof of the common atrium into the
lumen.
This crest is the first portion of the septum primum
The two limbs of this septum extend toward the
endocardial cushions in the atrioventricular canal.
The opening between the lower rim of the septum
primum and the endocardial cushions is
the ostium primum .
With further development, extensions of the superior and
inferior endocardial cushions grow along the edge of the
septum primum, closing the ostium primum .
Inter atrial Septum formation

Septum primum

Ostium primum

Septum intermedium
 Inter atrial Septum formation
Before closure is complete, cell death produces
perforations in the upper portion of the septum primum.
Coalescence of these perforations forms the ostium
secundum, ensuring free blood flow from the right to the
left primitive atrium .
When the lumen of the right atrium expands as a result
of incorporation of the sinus horn, a new crescent-
shaped fold appears.
This new fold, the septum secundum, never forms a
complete partition in the atrial cavity
 Inter atrial Septum formation

Its anterior limb extends downward to the septum

intermedium.
The free concave edge of the septum secundum begins
to overlap the ostium secundum.
The opening left by the septum secundum is called the
oval foramen (foramen ovale).
When the upper part of the septum primum gradually
disappears, the remaining part becomes the valve of
the oval foramen.
Inter atrial Septum formation

Septum secundum
Ostium secundum
Septum primum

Septum intermedium
Inter atrial Septum formation

Septum secundum
Ostium secundum
Foramen ovale

Septum intermedium
 Inter atrial Septum formation
The passage between the two atrial cavities consists of
an obliquely elongated cleft through which blood from
the right atrium flows to the left side
After birth, when lung circulation begins and pressure in
the left atrium increases, the valve of the oval foramen is
pressed against the septum secundum.
The septum primum (lower part) forms the fossa ovalis.
The lower margin of septum secundum forms the limbus
fossa ovalis
Inter atrial Septum formation
 Development of left atrium
Initially, a single embryonic pulmonary vein develops as
an outgrowth of the posterior left atrial wall, just to the left of
the septum primum.
This vein gains connection with portions of the right and left
atrium.
Both the wall of the right sinus horn (blue) and the
pulmonary veins (red) are incorporated into the heart to form
the smooth-walled parts of the atria.
During further development, the pulmonary vein and its
branches are incorporated into the left atrium, forming the
large smooth-walled part of the adult atrium.
Although initially one vein enters the left atrium, ultimately
four pulmonary veins enter as the branches are
incorporated into the expanding atrial wall.
Coronal sections through the heart to show development of the smooth walled
portions of the right and left atrium. Both the wall of the right sinus horn (blue)
and the pulmonary veins (red) are incorporated into the heart to form the smooth-walled
parts of the atria. veins of the developing lung buds. During further development, the
pulmonary
 Development of Atria
In the fully developed heart, the original embryonic
(primitive) left atrium is represented by little more than
the trabeculated atrium, while the smooth-walled part
originates from the pulmonary veins.
On the right side the original embryonic (primitive) right
atrium becomes the trabeculated anterior rough part
containing the pectinate muscles, and the smooth-walled
sinus venarum originates from the right horn of the sinus
venosus.
 Adult components of right & left atria & their
embryonic source of development
Adult component Embryonic source of development
RIGHT ATRIUM
ROUGH TRABECULATED PART IN FRONT OF Primitive atrium(right half)
CRISTA TERMINALIS

-right auricle --------

-smooth part behind crista -sinus venosus
terminalis(sinus venerum)of
-crista terminalis valve of IVC & valve of -from right venosus valve
coronary sinus
-most ventral smooth part -right half of AV canal
Left atrium
-posterior smooth part between the Endocardial proliferations
openings of pulmonary veins
-anterior rough part and left auricle Left half of primitive atrium
-most ventral smooth part Left half of the AV canal
 CLINICAL ANATOMY
ATRIAL SEPTAL DEFECT: ASD
Defect in the septum which results in the
communication between right and left atrium.
occurs in 6.4/10,000 births
female to male ratio 2:1
there is mixing of oxygenated and
deoxygenated blood giving rise to cyanosis,
breathlessness etc
 CLINICAL ANATOMY
ASD types:
-Septum primum defect
-Septum secundum defect
-Persisting foramen ovale
-Premature closure of foramen ovale
 Interventricular septum formation

By the end of the fourth week, the bulboventricular

cavity begin to expand.
This is accomplished by continuous growth of the
myocardium on the outside and continuous
diverticulation and trabecula formation on the inside
The medial walls of the expanding ventricles become
apposed and gradually merge, forming the muscular
interventricular septum .
The interventricular foramen, above the muscular
portion of the interventricular septum, shrinks on
completion of the conus septum .
 Interventricular septum formation

During further development, outgrowth of tissue

from the endocardial cushion along the top of the
muscular interventricular septum closes the foramen
This tissue fuses with the abutting parts of the conus
septum.
Complete closure of the interventricular foramen by
these endocardial cushions forms the membranous
part of the interventricular septum.
Interventricular septum formation

Conus septum

Endocardial cushion

Muscular interventricular septum

 Adult components of right & left ventricles &
their embryonic source of development
Adult component Embryonic source of development
Right ventricle
-inflowing rough part Proximal 1/3 of Bulbus cordis
-out flowing smooth part(infundibulum) conus cordis
Left ventricle
-inflowing rough part Primitive ventricle
-out flowing smooth part aortic vestibule) conus cordis
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