Pericardiophrenic Artery, Anterior View

Description

Running inferiorly along the fibrous pericardium, the pericardiophrenic artery descends with the phrenic nerve between mediastinal pleura laterally and pericardium medially, heading toward the central tendon of the diaphragm. From an anterior perspective in a male thorax, the vessel can be followed from its origin at the internal thoracic artery (via the musculophrenic or directly) into the superior mediastinum, where it tracks anterior to the root of the lung and near the pericardiophrenic veins. The heart occupies the central mediastinum posterior to the sternum, with the lungs positioned laterally and the diaphragm forming the inferior boundary, so the pericardiophrenic neurovascular bundle reads as a vertical landmark along the cardiophrenic region. Small pericardial branches radiate medially toward the pericardial sac. This relationship matters in pericardial and diaphragmatic disease because the phrenic nerve is the structure you protect, and the pericardiophrenic artery is often the vessel you see. During a pericardial window (subxiphoid or anterior thoracoscopic), unexpected bleeding can come from pericardiophrenic branches, while traction or thermal injury near the bundle can translate into postoperative hemidiaphragmatic paralysis. The anterior course also helps explain why pericardiophrenic vein enlargement can appear along the cardiophrenic angle when collateral pathways develop in superior vena cava obstruction. A clean corridor, but not forgiving. Use this artwork in thoracic anatomy teaching (mediastinum and diaphragm), cardiothoracic surgery and anesthesia materials that cover pericardiotomy and phrenic nerve preservation, and radiology references correlating cardiophrenic angle findings on chest radiograph or CT. It also fits clinical education on pericarditis, pericardial effusion drainage, and diaphragmatic dysfunction after cardiac surgery. Anatomical accuracy verified by SciePro's Medical Advisory Board.