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DEVELOPMENT OF
THE HEART
•Cardiac progenitor cells in
the epiblast migrate along
the primitive streak to the
lateral plate mesoderm layer
in a U-shaped manner.
•They form myoblasts &
blood islands.
•These cells unite to form 2
endocardial heart tubes.
•The vascular system
appears in the middle of the
3rd week.
•The folding of the embryo
leads to fusion of the 2 tubes
forming one primitive heart
tube.
• The heart tube is
suspended in the pericardial
cavity by dorsal
mesocardium which
disappear later leaving a
spasce known as the
transverse sinus of the
pericardium
Formation of cardiac loop:
• The heart tube elongates & bends
on day 23.
• The cephalic portion bends
ventrally & caudally & the atrial
caudal portion is shifted
dorsocranially & to the left.
• This bending creates the cardiac
loop which is completed by day 28
Formation of primitive heart
chambers:
• 3 constrictions appear in the
cardiac loop dividing it into 4
chambers:
• From below upwards they
include:
1) Sinus venosus.
2) Primitive atrium.
3) Primitive ventricle.
4) Bulbus cordis.
 Development of the
definitive heart
chambers
THE SINUS VENOSUS:
The sinus venosus is formed of a median part & 2
lateral horns.
Each horn receives 3 veins:
1) Common cardinal vein: Receives blood from the
whole body.
2) Umbilical vein: Receives blood from the placenta.
3) Vitelline vein: Receives blood from the yolk sac.
- Anastomosing veins connect the veins of the Rt.
& Lt. sides of the body & shift blood from the Lt.
to the Rt. veins.
- The Rt. horn enlarges in size while the Lt. one
becomes small
FATE OF SINUS VENOSUS:

•The Rt. Horn of sinus

venosus is absorbed into the
Rt. Atrium forming sinus
venarum of the Rt. Atrium.
•The Lt. horn remains small
in size & forms the coronary
sinus.
•The Lt. umbilical & Lt.
vitelline veins degenerate
•The Lt. common cardinal
vein forms the oblique vein
of the Lt. atrium.
•The Rt. Common cardinal
vein forms the SVC.
•The Rt. Vitelline vein forms
the IVC.
•The Rt. Umbilical vein
degenerates.
•The Lt valve of the sinus
fuses with the interatrial
septum. The Rt. Valve of the
sinus forms:
- Crista terminalis of the
Rt. Atrium
- The valve of the IVC.
- The valve of the coronary
sinus
 DEVELOPMENT OF THE
ATRIO-VENTRICULAR
CANAL (AVC)
• Endocardial cushions develop in
the canal, enlarge & fuse together
forming SEPTUM INTERMEDIUM
which divides the canal into RT.
(Tricusipid & Lt. (Mitral) atrio-
ventricular canals.
 Septum formation in the
common atrium
• At the end of the 4th week
a sickle-shaped “septum
primum” grows from the
roof of the common
atrium. The 2 limbs of
the septum fuse with
endocardial cushions of
AV canal.
• The opening between the
free border of septum
primum & the
endocardial cushion is
called ostium primum &
is closed by the growth
of endocardial cushion.
• Cellular death produces
another opening in the
upper part of septum
primum known as
“ostium secundum”.
• Another sickle-shaped
“septum secundum”
grows overlapping
ostium secundum. Its
limbs fuse with the
endocardial cushion.
• The opening between the
free margin of septum
secundum & the
endocardial cushion is
known as foramen ovale.
• The lower part of septum
primum forms the valve
of foramen ovale.
Further development of atria:

• The wall of the common

atrium forms the
trabeculated part of the Rt. &
Lt. atria.
• The smooth part of the
Rt.atrium is derived from the
absorbed Rt. Horn of sinus
venosus & is called sinus
venarum.
• The smooth part of the Lt.
atrium is derived from the
absorbed pulmonary veins.
 DEVELOPMENT OF
ATRIOVENTRICULAR VALVES

• 3 mesenchymal proliferation in the Rt.

AV opening develop to form the
tricuspid valve & 2 in the Lt. AV
opening develop to form the mitral
(bicuspid) valve.
• The leaflets of the valves remain
connected to the wall of the ventricles
by chordae tendineae & papillary
muscles.
DEVELOPMENT OF THE
VENTRICLES
• The common
ventricle
develops to form
the rough
trabeculated part
of the left
ventricle only.
• The proximal part
of the bulbus
cordis develop to
form the rough
trabeculated part
of the left
ventricle.
• The middle part
of bulbus cordis
(Conus Cordis)
forms the
smooth outflow
part of both the
Rt. & Lt.
ventricles.
 SEPTUM FORMATION IN
THE VENTRICELS
• The medial
wall of the
RT. & Lt.
ventricles are
apposed
&finally fuse
together
forming the
muscular part
of the
interventricul
ar septum.
• The
endocardial
cushion of
the AV canal
& truncus
arteriosus
form the
membranous
part of the
interventricul
ar septum.
 DEVELOPMENT OF BULBUS
CORDIS
1) The proximal
part forms the
trabecular part of
the Rt. ventricle.
2) The middle part
(Conus cordis)
forms the
smooth parts of
the ventricles.
3) The distal part
(Truncus
Arteriosus):
Endocardial
cushions
develop & form a
spiral aortico-
pulmonary
septum which
divide the
truncus
arteriosus into
aorta &
pulmonary trunk.
 DEVELOPMENT OF
SEMILUNAR VALVES
• 3 endocardial swellings appear in the aortic & in
pulmonary openings.
• As development proceed these swellings
become excavated from their upper surface &
form the aortic & pulmonary semilunar valves.
 ANAOMALIES OF
INTERATRIAL SEPTUM
1) Atrial septal defect:
- Ostium secundum
defect may result from
very large ostium
secundum or too small
septum secundum.
- Ostium primum defect.
- Common atrium (Cor
triloculare
biventriculare) reuslts
from complete failure
of development of
interatrial septum.
5) Premature closure of
foramen ovale: Results
in atrophy of the left
side of the heart which
ruptures shortly after
birth with the return of
blood from the lung to
the left atrium.
6) Probe patent foramen
ovale: in 20% of cases
septum primum &
secundum do not fuse
together without
shunting of blood.
 ANOMALIES OF
INTERVEMTRICULAR SEPTUM
• Ventricular septal defect (VSD):
May be found in the membranous or muscular part
of the interventricular septum.
 ANOMALIES OF TRUNCUS
ARTERIOSUS
1) Fallot’s tetralogy:
Results from
deviation of aortico-
pulmonary septum
resulting in:
- Stenosis of
pulmonary trunk.
- overriding aorta.
- ventricular septal
defect.
- hypertrophy of the
right ventricle.

2) Persistent truncus
arteriosus due to
failure of
development of
aortico-pulmonary
septum.

3) Transposition of great
vessels: The aorta
arises from the right
ventricle & the
pulmonary trunk from
the left ventricle due
to development of the
aortico-pulmonary
septum in a straight
manner.
 ANOMALIES OF THE VALVES

ATRESIA OF TRICUSPID
VALVE

ATRESIA OF PULMONARY ATRESIA OF AORTIC

VALVE VALVE
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