ONTOGENI OF THE HEART

Formation of the heart tube

The primordium of the heart is first evident at
18 days and begins to beat at 22 to 23 days.
In the cardiogenic area, splanchnic
mesechymal cells aggregate and arrange
themselves side by side to form two
longitudinal, cellular cardiac primordia,
angioblastic cords.
The cords become canalized to form two
endocardial heart tubes.

Mesoderm layer

Formation of the heart tube

As lateral embryonic folding occurs, the
endocardial tubes approach each other and
fuse to form a single endodardial heart tube.
The heart tube starts to bulge into the
pericardial cavity, meanwhile, the endocardial
tube becomes surrounded by a thick layer
mesenchyme, which will differentiate into the
myocardium and visceral layer of the serous
pericardium.

Formation of the heart tube

The primitive heart has been established, and
the cephalic end is the arterial end, and the
caudal end is the venous end.
The arterial end of the primitive heart is
continous beyond the pericardium with a
large vessel, the aortic sac. From which the
aortic arches arise.

 Concurrently, the tubular heart elongates and

develops alternate dilatations and
constrictions. These delatatos are called
Truncus arteriosus
Bulbus cordis
Ventricle
Atrium
Sinus venosus

 The sinus venosus receives the umbilical,

vitelline, and common cardinal veins
Because the bulbus cordis and ventricle grow
faster than other regions, the heart bends
upon itself, forming a U-shaped
bulboventricular loop,and then form S shape,
with the atrium lying posterior to the
ventricle; thus the venous and arterial ends
are brought close together.

 The sinus venosus has develops laterally

expansions, the right and left horn of the sinus
venosus.
The passage between the atrium and the
ventricle narrows to form the atrioventricular
canal.

Development of the Atria

The primitive atrium becomes divided into
two atria, the right and the left atria--- in the
following manner
First, the atrioventricular canal divided into
right and left by the appearance of ventral and
dorsal atrioventricular cushion, which fuse
form the septum intermedium.

 Meanwhile, another septum, the septum

primum, develops from the root of the
primitive atrium and grows down to fuse with
the septum intermedium.
Before fusion occurs, the opening between
the lower edge of the septum primum and the
septum intermedium is referred to as the
foramen primum. The atrium now is divided
into right and left parts.

 Before the complete obliteration of the

foramen primum has taken place, degeneraive
changes occur in the central portion of the
septum primum, a formen appears, the
foramen secundum. So that the right and left
atria chambers again communicate.
Another thicker septum grows down from the
atrial roof on the right side of the septum
primum called septum secundum.

 The lower edge of the septum secundum

overlaps the foramen secundum in the
septum primum but does not fuse with the
septum intermedium. The space between the
free margin of the septum secundum and the
septum primum is now known as the foramen
ovale.

 Before birth, the foramen ovale allows blood

from the right atrium to pass into the left
atrium, However, the lower part of the
septum primum serves as a flap-like valve to
prevent blood moving from the left to the
right atrium.

 At birth, due to raised blood pressure in the

left atrium, the septum primum is pressed
against the septum secundum and fuses with
it, and the foramen ovale is closed

Fetal circulation
Highly oxygenated, nutrient rich blood returns from
the placenta in the umbilical vein
On approaching the hepar about half of the blood
directly into the ductus venosus, a fetal vessel
connecting the umbilical vein to the Inferior vena
cava (IVC). The other half of the blood in the
umbilical vein flows into sinusoid of the hepar and
enter to the IVC through hepatic vein

Fetal circulation

Neonatal circulation
Important circulatory adjustments occur at
birth when the circulation of fetal blood
through the placenta ceases and the infants
lungs expand and begin to function. Three
shunts the permitted much of blood to bypass
the liver and lungs close and cease to
function.

 As soon as the baby is born, The foramen ovale is

closed. Ductus arteriosus, ductus venosus, and
umbilical vessels are no longer needed.
Aeration of the lungs at birth is associated with:
A dramatic fall in pulmonary vascular resistance
A marked increase in pulmonary blood flow
A progressive thinning of the walls of the pulmonary
arteries, results mainly from stretching as the lungs
increase in size with the first few breath

Neonatal circulation

Adult Derivatives of Fetal vascular

structures
Because of changes in the cardiovascular
system at birth, certain vessels and structures
are no longer required. Over a period of
months, these fetal vessels form
nonfunctional ligaments, and fetal structures
such as the foramen ovale persist as
anatomical vestiges of the prenatal circulatory
system

Fetal circulation
Highly oxygenated, nutrient rich blood returns from
the placenta in the umbilical vein
On approaching the hepar about half of the blood
directly into the ductus venosus, a fetal vessel
connecting the umbilical vein to the Inferior vena
cava (IVC). The other half of the blood in the
umbilical vein flows into sinusoid of the hepar and
enter to the IVC through hepatic vein

Fetal circulation

Neonatal circulation
Important circulatory adjustments occur at
birth when the circulation of fetal blood
through the placenta ceases and the infants
lungs expand and begin to function. Three
shunts the permitted much of blood to bypass
the liver and lungs close and cease to
function.

 As soon as the baby is born, The foramen ovale is

closed. Ductus arteriosus, ductus venosus, and
umbilical vessels are no longer needed.
Aeration of the lungs at birth is associated with:
A dramatic fall in pulmonary vascular resistance
A marked increase in pulmonary blood flow
A progressive thinning of the walls of the pulmonary
arteries, results mainly from stretching as the lungs
increase in size with the first few breath

Neonatal circulation

Adult Derivatives of Fetal vascular

structures
Because of changes in the cardiovascular
system at birth, certain vessels and structures
are no longer required. Over a period of
months, these fetal vessels form
nonfunctional ligaments, and fetal structures
such as the foramen ovale persist as
anatomical vestiges of the prenatal circulatory
system

The Change of fetal circulation

Umbilical vein eventually bcomes the
ligamentum teres Hepatis
Ductus venosus becomes the ligamentum
venosum Arrantii
Framen ovale closed, called fossa ovalis. Closure
occurs by third month after birth
Ductus arteriosus, usually closure compeltely
within thw first few days after birth

The Change of fetal circulation

Ductus arteriosus, usually closure compeltely
within thw first few days after birth. These
vessel normally close by 12 week after birth
Umbilial arteries,the proximal part become
of these vessels become superior vesical
arteries, and the distal part become medial
umbilical ligaments.

Congnital Anomalies
Dextrocardia
Ectopic cordis
Atrial Septal Defects (ASD), is common
congenital heart anomaly
Ventricular Septal Defects is the most
common type CHD
Foramen ovale persistent
Patent Ductus Arteriosus, usually closed soon
after birth

Congnital Anomalies

Persistent Truncus Arteriosus

Transposition of the Great Arteries
Pulmonary atresia
Tetralogy of Fallot
Pulmonary stenosis
VSD
Overriding Aortae
Right ventricular hypertrophy

ASD
Ostium secundum defect
Endocardail cushion defect with ostium
primum defect
Sins venosus defect
Common atrium

Tetralogy of Fallot