Apex of the heart

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Apex of the heart

Sternocostal surface of heart (apex is not labeled, but is visible at bottom right)
Latin	Apex cordis
Gray's	subject #138 527

The apex of the heart is the lowest superficial part of the heart.

It is directed downward, forward, and to the left, and is overlapped by the left lung and pleura.

External anatomy [edit]

It lies behind the fifth left intercostal space, 8 to 9 cm from the mid-sternal line, slightly medial to the midclavicular line.

Alternately, it can be found about 4 cm below and 2 cm to the medial side of the left mammary papilla.

This article incorporates text from a public domain edition of Gray's Anatomy.

General

Surface	base · apex · grooves (coronary/atrioventricular, interatrial, anterior interventricula, posterior interventricular) · surfaces (sternocostal, diaphragmatic) · borders (right, left) · Openings of smallest cardiac veins

Internal	atria (interatrial septum, musculi pectinati, sulcus terminalis) · ventricles (interventricular septum, trabeculae carneae, chordae tendineae, papillary muscle) · valves · cusps · Atrioventricular septum cardiac skeleton Intervenous tubercle

Chambers

Right heart	(venae cavae, coronary sinus) → right atrium (atrial appendage, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve of inferior vena cava, valve of coronary sinus) → tricuspid valve → right ventricle (conus arteriosus, moderator band/septomarginal trabecula) → pulmonary valve → (pulmonary artery and pulmonary circulation)

Left heart	(pulmonary veins) → left atrium (atrial appendage) → mitral valve → left ventricle → aortic valve (aortic sinus) → (aorta and systemic circulation)

Layers

Endocardium	Heart valves

Myocardium	Conduction system: Cardiac pacemaker · SA node · AV node · bundle of His · Purkinje fibers

Pericardial cavity	Pericardial sinus

Pericardium	fibrous pericardium (Sternopericardiac ligaments) · serous pericardium (epicardium/visceral layer) · Fold of the left vena cava