Posterior Display of the Inferior Interventricular Sulcus

Description

Arising on the diaphragmatic surface of the heart, the inferior interventricular sulcus runs inferiorly toward the apex, separating the right and left ventricles on the posterior aspect. Nested within this groove, the posterior interventricular artery (posterior descending artery) typically courses with the middle cardiac vein, while the coronary sinus lies more superiorly in the posterior atrioventricular (coronary) sulcus. Right ventricular myocardium sits to the viewer’s right of the sulcus and left ventricular myocardium to the viewer’s left, with the sulcal fat pad often forming a shallow trough around the vessels. Orientation is posterior. This posterior perspective matters because it maps the arterial supply to the inferior wall and posterior third of the interventricular septum, territories implicated in inferior ST elevation myocardial infarction when the culprit is the right coronary artery in right dominant circulation. The relationship between the posterior interventricular artery and the middle cardiac vein is also a practical landmark during coronary artery bypass grafting and in procedures involving the coronary sinus, such as left ventricular lead placement for cardiac resynchronization therapy. Small spatial misunderstandings here translate into real procedural risk. Use this artwork in gross anatomy and cardiology teaching to clarify ventricular topography on the diaphragmatic surface, and in surgical or interventional publications discussing coronary dominance, inferior wall ischemia, or posterior descending artery graft targets. It also supports radiology correlation when introducing how posterior coronary vessels are inferred on CT coronary angiography and catheter angiograms. Anatomical accuracy verified by SciePro's Medical Advisory Board.