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The outer tissue layer covering the heart, with developmental contributions to supporting cells and signals affecting myocardial and coronary development.

Generalized anxiety disorder involves persistent, excessive worry across several areas of life that is difficult to control and interferes with functioning. Associated changes can include restlessness, tension, fatigue, sleep difficulty or problems concentrating.^[ref]

The breadth and persistence of worry distinguish it from an isolated moment of stress. Similar physical arousal can occur in other conditions, so an individual symptom such as a racing heart does not by itself identify the disorder.

The great cardiac vein ascends in the anterior interventricular sulcus with the left anterior descending artery, then turns into the coronary sulcus toward the coronary sinus.^[ref] These two successive landmarks make its route easier to reconstruct than a list of isolated vessel names.

For example, an anterior view shows the portion near the ventricular boundary, whereas following the same vein around the left side of the heart reveals its relation to the atrial–ventricular boundary. The change of surface direction does not create a different venous drainage system. It is one connected return route within the coronary circulation.

The relationship to nearby arteries is variable. In a series of 37 dissected hearts, the great cardiac vein was adjacent to the circumflex artery within the coronary sulcus in $76\%$ of specimens; other configurations occurred in the remainder.^[ref] This makes a useful experimental distinction between finding a common pattern and demonstrating a necessary anatomical rule. A vessel's observed course supports identification, but its connection to the coronary sinus and the direction of tissue return supply the functional meaning. Proximity to a coronary artery does not mean that the vein carries the same blood directly from that artery without intervening tissue exchange.

Heart development produces the pumping organ, its chambers, lining and supporting structures through coordinated differentiation and morphogenesis. The early heart tube changes shape through cardiac looping and receives further cellular contributions; changes in shape, cell number and cell identity are separable processes.

In zebrafish, fluorescent developmental-timing assays and a photoconvertible fluorescent protein distinguished early differentiation from later addition at the arterial pole of the heart. These experiments showed why growth of the heart cannot be explained solely by division of already differentiated cardiac cells.^[ref]

A heart murmur is an additional or prolonged sound associated with blood flow through the heart or nearby vessels, heard during auscultation. It differs from the usual brief heart sounds associated with valve closure. Some murmurs accompany structural or flow abnormalities, while others occur without significant structural disease. The sound is an observation contributing to clinical diagnosis, rather than a diagnosis uniquely identifying its cause. ^[ref]

A heart valve permits predominantly one-way blood flow through the heart. Leaflet motion follows changing pressure differences and structural constraints. The four main human valves occupy different chamber or outflow boundaries, so valve dysfunction has location-specific consequences.^[ref]

A hypophyseal portal vein is a vein connecting the first and second capillary networks of the hypophyseal portal system. The main route carries blood from the median eminence region of the hypothalamus, down the pituitary stalk, to the anterior pituitary. It delivers hypothalamic hormones before their dilution in the wider circulation.^[ref]

The word “portal” describes the route: blood leaving one capillary bed reaches another capillary bed before returning to the heart. Here the first bed receives a regulatory message and the second delivers it to responding biological cells. A hypophyseal portal vein is therefore an interconnecting segment, rather than the entire hypophyseal portal system.

A useful example is a pulse of gonadotropin-releasing hormone. In conscious sheep, simultaneous sampling of portal and peripheral blood plasma linked portal GnRH pulses with peripheral luteinizing hormone episodes. Sampling the hypophyseal portal vein route accesses the incoming hypothalamic signal; peripheral sampling detects the resulting pituitary output. That distinction is why the sampling location is part of the experiment, not just a convenient place to draw blood.^[ref]

The interventricular septum is the partition separating the cavities of the right ventricle and left ventricle. It is internal to the heart, unlike the external anterior interventricular sulcus and posterior interventricular sulcus. The distinction can be seen by comparing an intact surface view with an opened view of the ventricular chambers.^[ref]

An intact partition lets the two ventricular pumps operate at different blood pressure values without a direct open route between their cavities. An elementary physical model makes the role clear: if a hypothetical opening connected two chambers, a pressure gradient across that opening could drive an additional blood flow. Conservation would then require a term for transfer between chambers, in addition to the flow through their respective heart valves. This thought experiment explains why a partition is part of the circulation's topology, rather than merely a line on an anatomical drawing.

The interventricular septum also belongs to the mechanically connected ventricular structure. Consequently, measuring right ventricular ejection fraction and measuring left ventricle function describe two chambers in one coupled heart, rather than two unrelated pumps. For an anatomical identification exercise, first find the two cavities, then identify their common separating wall; locating a surface groove alone does not establish the wall's thickness or internal structure.

A surgeon who reported a case combining intestinal obstruction by a gallstone with rupture of the heart. The account linked clinical events with observations of a friable ventricular wall; it establishes a case, not a universal causal sequence.^[ref]

Surgeon in Peebles named with these initials in Gallstone ileus with rupture of the heart by J. B. Junor. The source establishes the initials and affiliation, not full forenames or biographical dates. A bounded name-and-affiliation portrait search did not establish an authentic portrait or an exact Wikipedia article.

The left atrium is the heart chamber receiving blood through the pulmonary veins and delivering it through the mitral valve to the left ventricle. It is the receiving chamber on the oxygenated return side of the pulmonary circulation.^[ref]

Its role changes during the cardiac cycle. The chamber can accumulate incoming blood while its outlet is closed, pass blood onward during ventricular filling, and contribute to late filling through atrial contraction. The storage role is called atrial reservoir function.^[ref]

A volume balance makes this more precise:Here the sum includes the incoming pulmonary vein blood flow rates, and the outlet term is signed net flow through the mitral valve. In a constructed interval with total inflow $5$ L/min and zero outlet flow for $0.10$ s, the stored volume increases byThe example describes transient storage, not an indefinitely sustained steady state. Over a repeating cycle with no net accumulation, average inflow must equal average outflow.

The entering streams can also differ in oxygen content. Their mixed content is weighted by their blood flow rates, not by the number of vessels. Thus the same anatomical chamber supports two distinct balance questions: how its volume changes with time, and how transported oxygen combines. Its volume alone determines neither the stroke volume of the left ventricle nor the oxygen content entering the left ventricle.

The left coronary artery is a principal coronary artery arising from the proximal aorta. Its typical major branches are the left anterior descending artery and the circumflex artery, which distribute blood to different regions of the heart.^[ref] A main trunk and one of its branches are different anatomical levels; a finding in one should not be silently attributed to the other.

The adjective left does not partition the entire heart into two exclusive arterial territories. Coronary dominance and branching variations alter posterior supply, and a right-coronary system can supply substantial parts of the left ventricle. Injected-heart and X-ray observations demonstrate variation even within right-dominant specimens.^[ref]

An original two-branch conservation of mass model makes the trunk-versus-branch distinction quantitative. If the modeled trunk has only two outlets and negligible accumulation,Chosen branch flows $110$ and $70\mathrm{mL}\mathrm{mi}{\mathrm{n}}^{-1}$ give trunk flow $180\mathrm{mL}\mathrm{mi}{\mathrm{n}}^{-1}$. Measuring only the first branch would not supply the total. If other branches or alternate routes carry flow, their terms must be included rather than forced into this two-outlet model.

Likewise, the consequences of a narrowed main segment and a narrowed distal branch need not be interchangeable. They occupy different positions in a network. A physiological inference requires the actual routes, their resistances and the represented tissue, not merely the shared word coronary.

The left coronary artery is therefore a useful anatomical reference for interpreting coronary angioplasty, branch-level measurements and oxygen-supply models. A measured diameter identifies geometry at a selected location; coronary oxygen delivery additionally requires flow and arterial oxygen content. These observations must refer to compatible territories before they are combined.

The left marginal branch is a branch of the circumflex artery running toward the left ventricular margin and supplying part of the left ventricle. It belongs to the arterial supply of the heart's tissue, rather than to the blood flow ejected from the ventricular cavity.^[ref]

The parent connection is important: left identifies the relevant side, and marginal describes a course near a ventricular margin. A surface vessel in that region should not be identified solely by proximity. Tracing its origin from the circumflex artery distinguishes an arterial branch from a nearby cardiac vein and from branches of the right coronary artery.

Selective contrast injection provides an experimental way to examine such branching. A primary 1967 report described preformed catheters for selective coronary angiography, with serial or cine imaging in 100 consecutive patients.^[ref] The resulting image reveals a filled vascular route; it does not directly measure how much tissue oxygen was consumed along that route.

A simple branch balance illustrates the additional information needed. If total blood flow entering a segment of the circumflex artery is 100 mL/min and 30 mL/min enters one left marginal branch, the remaining downstream branches receive 70 mL/min in a no-storage model. The parent flow alone cannot determine the split. Vessel geometry, vascular resistance and the measurement location all affect what a branch-flow observation means.

A live birth is delivery of offspring showing signs of life after separation from the mother. In human vital statistics, breathing or a beating heart can provide such evidence; being born alive and surviving the subsequent neonatal period are distinct outcomes.^[ref]

In comparative reproduction, delivery of living young is associated with viviparity, whereas oviposition releases eggs whose embryonic development continues outside the maternal body. The evolutionary question concerns where and how the developing offspring is supported, rather than whether the mother produces ova.

Lyme disease is a tick-borne bacterial infection caused by members of the Borrelia burgdorferi species complex and transmitted by infected Ixodes ticks. Early illness can include fever, fatigue and an expanding rash called erythema migrans; later involvement can affect joints, the nervous system or the heart. The rash has varied appearances and need not form a textbook bullseye.^[ref]

The bacterial link emerged from a specific line of evidence. In 1982, Willy Burgdorfer and colleagues reported spirochaetes in ticks from an affected area, cultivation of the organisms, and reactions with antibodies from patients with Lyme disease. This connected a vector-associated organism to the human illness, rather than inferring a cause from an association with outdoor exposure alone.^[ref]

A developmental biologist who investigated asymmetric PITX2 signaling and its relationship to heart and gut looping; the primary record credits these initials.^[ref]

The mediastinum is the central compartment of the thorax between the pleural sacs. It contains the heart, major vessels, trachea, oesophagus and other structures. The lungs occupy the adjacent pleural regions, so an abnormality described as mediastinal is not automatically within lung tissue.

The middle cardiac vein follows the posterior interventricular sulcus and drains into the coronary sinus. Its course is associated with the posterior descending artery on the posterior/inferior surface of the heart.^[ref] It is a cardiac vein, carrying return from heart tissue rather than serving as an outlet from a ventricular cavity.

For specimen orientation, first identify the posterior interventricular sulcus, then trace the middle cardiac vein toward its junction with the coronary sinus. Tracing the neighboring posterior descending artery instead leads back toward an arterial source. The same surface corridor thus supports two different paths through the coronary circulation.

Connections can also cross the simplified boundaries of a schematic drainage map. A primary dissection study reported an approximately 1 mm connection between the anterior and posterior interventricular venous routes in $19\%$ of its 37 specimens.^[ref] This observation illustrates a network property: drawing separate named tributaries does not prove that they are isolated tubes. For an oxygen-balance experiment using a venous sample, the actual drainage connections determine which tissue contributions can reach the sample. Neither the vessel's name nor its surface position alone specifies an exact sampled tissue volume.

The mitral annulus is the supporting attachment region around the mitral valve between the left atrium and left ventricle. It supplies a reference for the valve leaflets but is not adequately described as a rigid, flat circle. Its spatial shape and motion form part of the coupled valve apparatus.

A primary left-heart simulator study compared flat and saddle-shaped annular configurations in eleven human valve specimens. The investigators measured chordae tendineae forces in selected experiments and found a redistribution of those forces with annular shape.^[ref] This tests a geometrical variable directly rather than assuming that one diameter captures the complete attachment boundary.

An original circular approximation illustrates why fractional diameter and area changes differ. If a hypothetical ring's diameter changes from $D$ to $0.9D$, its planar area changes from $\pi D^2/4$ to $0.81\pi D^2/4$. A $10\%$ diameter decrease gives a $19\%$ area decrease in this model. The equation is not a claim that the native mitral annulus is circular or planar.

Motion adds another geometrical contribution. In a rigid-piston model, translation of a boundary with area $A$ by distance $\Delta z$ changes the represented volume by $\Delta V=A\Delta z$. Stipulated values 10 cm${}^2$ and 0.4 cm give 4 mL. Actual mitral annular excursion occurs in a deforming heart, so this does not assign all stroke volume to one translating plane.

Annular area, shape, position and leaflet coaptation are therefore related but distinct observations. Comparisons need consistent landmarks and phases, while models must specify which parts of the surrounding apparatus are allowed to move.

Mixed venous oxygen content is the oxygen content of blood after the returning venous streams have mixed, representing whole-body venous return to the right side of the heart. It is the venous quantity required with arterial oxygen content in the whole-body Fick principle. A single regional vein need not have this content: different tissues remove different amounts of oxygen and return different blood flow rates.

The mixing rule follows from conservation of mass. If streams have blood flow rates $Q_i$ and venous oxygen content values $C_i$, with no oxygen exchange during mixing,For two constructed streams, $100$ mL/min at $0.05$ mL of oxygen per mL of blood and $50$ mL/min at $0.20$ mL/mL carry $5$ and $10$ mL/min of oxygen. Their mixture has content $15/150=0.10$ mL/mL, not the unweighted mean $0.125$ mL/mL. The correct weights are volume blood flow rates.

The right atrium receives several returns before blood passes through the right ventricle and pulmonary trunk.^[ref] A downstream sample can represent their mixture only to the extent that the streams have actually mixed and the sampling interval represents the desired state. Replacing that sample with one taken from a particular upstream vein introduces a representativeness assumption. Likewise, averaging oxygen saturation values is not generally an oxygen-content balance when hemoglobin concentrations differ. The whole-body balance is about amounts of transported oxygen, not averages of instrument displays.

Death of heart-muscle tissue due to inadequate blood supply. It is a tissue injury, distinct from reversible ischaemia and from cardiac arrest, although either can accompany it.