EMBRYOLOGY OF

CARDIOVASCULAR SYSTEM
 ESTABLISHMENT AND PATTERNING
OF PRIMARY HEART FEILD
• vascular system appears in the middle of 3rd week
• Progenitor heart cells lies in the epiblast
• Immediately adjacent to the cranial end of primary streak
• From there they migrate through the streak
• Splanchnic layer of lateral plate mesoderm - Where they form a horse shoe
shaped cluster of cells – primary heart field (cranial to neural folds)
• As the progenitor cells migrate – form primary herat field – during 16-18 days
they are specified on both sides from lateral to medial to became atria LT
and RT ventricle
• Patterning of these cells occurs at the same time from laterally (lt –rt
sidedness )
• Established for entire embryo - this process is called signaling pathway-
depend upon normal heart development
• Remaining of the heart including part of right ventricle and outflow tract
(conus cordis, truncus arteriosus) – derived from secondary heart field
• Cells appears slightly later (20-21 days) than those in primary heart field
resides in splanchnic mesoderm, ventral to the posterior pharynx
• It is mainly responsible for lengthening the outflow tract
• Cells in the secondary heart field also exhibit laterally such that those on the
Rt side contribution to Lt side of outflow tract region
Lt side contribution to Rt side
• This laterality is determined by same signaling pathway which estlablishes
laterality for entire embryo.
• That explains the spiraling nature of the pulmonary artery and aorta
• Aorta exists from Lt ventricle pulmonary artery from Rt ventricle
• Once cells establish the Primary heart field
• They are induced by underlying pharyngeal endoderm to form cardiac
myoblasts and blood islands will forms blood cells and vessels by process of
vasculogenesis .
• With time the islands unite and form horse shoe shaped endothelial lined
tube surrounded by myoblasts
• This region is known as cardiogenic region
• Intraembryonic cavity over it later develops into pericardial cavity
• In addition to the cardiogenic region other blood islands appear bilaterally
parallel and close to the midline of embryonic shield
• These islands forms a pair of longitudinal vessels dorsal aortae
 FORMATION AND POSITION OF THE
HEART TUBE
• Initially the central portion of cardiogenic area is anterior to the
oropharyngeal membrane and neural plate
• With closure of the neural tube and formation of the brain vesicles
• However CNS grows cranially so rapidly extends over the central
cardiogenic region – future pericardial cavity
• As a result of growth of the brain and cephalic folding of the embryo
• Oropharyngeal membrane is pulled forward – while heart and pericardial
cavity move first to the cervical region and finally to thorax .
• As the embryo grows and bends cephalocaudally it also folds laterally
• As a result the caudal regions of the paired cardiac tube merge except at
their caudal most ends.
• Simultaneously the central part of horse shoe shaped tube expands to form
future outflow tract and ventricular region
• Thus the heart becomes a continuous expanded tube consisting of an inner
endothelial lining and outer myocardial layer
• It receives venous drainage at its caudal pole
• It begins to pump blood of the 1st aortic arch into dorsal aorta at its cranial
pole
• The developing heart tube bulges more and more into the pericardial cavity
• Initially however the tube remains attached to the dorsal side of the
pericardial cavity by fold of mesodermal tissue – dorsal mesocardium.
• No ventral mesocardium is ever formed.
• With further development dorsal mesocardium disappears creating
transverse pericardial sinus which connects both sides of pericardial cavity
• The heart is now suspended in the cavity by blood vessels as it cranial and
caudal poles
• During these events the myocardium thickens and stretches a thick layer of
extracellular matrix – rich in hyaluronic acid which separates it from
endothelium
• In addition to mesothelial cells on the surface of the septum transverse form
proepicardium
• Near the sinus venous at its caudal end and migrate over the heart to form
most of the epicardium
• Remainder of epicardium is derived from mesothelial cells originating in the
outflow tract region
• Heart tube: consists of 3 layers
A) Endocardium
B) Myocardium
C) Epicardium or visceral pericardium
A)Endocardium: forming internal endothelial lining of heart
B)Myocardium: forming the muscular wall
C)Epicardium or Visceral pericardium: covering the outside of the tube
• Outer layer is responsible for formation of coronary arteries including their
endothelial lining and smooth muscle.