The coronary sinus (sinus: from the Latin sinus, meaning curvature, coronary: from the Latin coronarius, meaning “in the shape of a crown”) is a structure of the vascular system of the heart.

Position. The coronary sinus is located at the level of the heart. The latter is composed of a right and left part. Each comprising an atrium and a ventricle. Between the atria and the ventricles, we can distinguish a groove called atrioventricular groove. The coronary sinus passes in the posterior part of this sulcus, as well as at the level of the right atrium (1) (2).

Origin. The coronary sinus is formed by the union of the posterior vein of the left ventricle and the large cardiac vein. This union takes place within the atrioventricular sulcus, and at the level of the left border of the heart (1).

Path. The coronary sinus continues to travel along the atrioventricular sulcus. During its journey, several veins join the coronary sinus, like the middle cardiac vein (1).

Termination. The coronary sinus ends by opening into the right atrium (1).

Venous return. The coronary sinus is a structure involved in the return of venous blood to the heart, i.e. blood low in oxygen (1) (2).

The coronary sinus can be affected during heart disease, pathologies that alter the functions of the heart. In most cases, these heart diseases are associated with pathologies of the coronary arteries, often affecting the functions of the coronary sinus.

Abnormal venous return. This rare pathology corresponds to a congenital malformation affecting the coronary veins. It causes the heart to malfunction which can lead to heart failure.

Myocardial infarction. Also called heart attack, myocardial infarction corresponds to the destruction of part of the myocardium. The cause of this pathology is the obstruction of a coronary artery supplying the myocardium. Deprived of oxygen, myocardial cells die and degrade. This destruction results in a dysfunction of the cardiac contraction which can lead to the stop of the heart. A myocardial infarction is manifested in particular by abnormal heart rhythms or heart failure (3).

Angina pectoris. Also called angina, angina pectoris corresponds to an oppressive and deep pain in the thorax. It occurs most often during exertion but can also appear during periods of stress and more rarely at rest. The cause of this pain is an inadequate supply of oxygen to the myocardium. This is often due to pathologies affecting the coronary arteries, responsible for the irrigation of the myocardium (4).

Medical treatment. Depending on the pathology diagnosed, certain drugs may be prescribed such as anticoagulants, antiaggregants, or even anti-ischemic agents.

Thrombolyse. This test consists of breaking up the thrombi, or blood clots, using drugs. This treatment is used during myocardial infarction. (3)

Surgical treatment. Depending on the pathology and its stage of development, a surgical intervention may be implemented. In the event of a myocardial infarction, angioplasty may in particular be performed.

Physical examination. First, a clinical examination is performed in order to study the heart rate in particular and to assess the symptoms perceived by the patient such as shortness of breath or palpitations.

Medical imaging exam. In order to establish or confirm a diagnosis, cardiac ultrasound or Doppler ultrasound can in particular be performed. They can be supplemented by a coronary angiography, a CT scan, or an MRI.

Electrocardiogram. This test allows you to analyze the electrical activity of the heart.

Electrocardiogramme d’effort. This test is used to analyze the electrical activity of the heart during physical exertion.

20th century South African surgeon Christiaan Barnard is famous for performing the first successful heart transplant. In 1967, he transplanted a heart from a young woman who died in a car accident to a man with coronary artery disease. This patient will survive after the operation but will succumb to pneumonia 18 days later (5). Since this first successful transplant, medical progress has continued, as evidenced by recent experiments with transplants from an artificial heart.