Anatomy of the Vessels and Nerves of the Trunk (Angioneurology) - Chornokulskyi S. T. 2011

Cardiovascular System
Topography of the Heart

The Heart is located in the middle (anterior according to BNA) Mediastinum asymmetrically, posterior to the anterior and anterior to the posterior mediastinum. Flanking the heart are the mediastinal pleurae, inferiorly is the Diaphragm, and superiorly are the Organs of the superior mediastinum. Anteriorly, the heart is partially covered by the Lungs as well.

The heart may assume an oblique, horizontal, or vertical position. The oblique position is considered normal; the horizontal position is typical for individuals with a brachymorphic constitutional type, whereas the vertical position is characteristic of those with a dolichomorphic type.

Borders of the heart (Fig. 21, 22)

This essentially represents the skeletotopy of the frontal silhouette of the heart; therefore, the upper, right, lower, and left borders of the heart are distinguished. It is advisable first to determine the projection site of the heart apex, which is located in the fifth left intercostal space 1 cm medial to the left midclavicular line (the site of Palpation of the cardiac apex beat).

Upper border — a line drawn along the upper borders of the third costal cartilages.

Right border — a vertical line connecting the upper border of the third right costal Cartilage (2–2.5 cm to the right of the sternal margin) with the lower border of the fifth right costal cartilage.

Lower border corresponds to the line drawn between the end of the right border and the projection site of the heart apex.

Left border — a line drawn between the upper border of the third left rib (midpoint of the distance: left sternal margin — left midclavicular line) and the apex of the heart.

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Fig. 22, a. A — chest radiograph of the heart, posteroanterior (frontal) projection, B — semi-schematic contours of the heart:

Right lateral contour of the heart:

1 - upper arch (shadow of the ascending aorta and SUPERIOR VENA CAVA)

2 - right and left — shadows of the lung roots

3 - lower arch (shadow of the right atrium)

Left lateral contour of the heart:

A — 1st arch (shadow of the aortic arch and the beginning of the descending aorta)

5 - 2nd arch (shadow of the pulmonary trunk)

6 - 3rd arch (shadow of the left auricle)

7 - 4th arch (shadow of the left ventricle)



Last update: 11/08/2026

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