Cardiac innervation: what we know from gross anatomy (543.1)

The cardiac plexus is an extensive network of nerves located posteroinferior to the arch of the aorta at the base of the heart. The cardiac plexus receives autonomic contributions from both cervical and upper thoracic sympathetic trunks as well as contributions from vagus nerves. It is a notoriously variable and complex area that makes for difficult dissection and classification. The cardiac nerves and their branches anastomose into what are often described as two plexuses with significant interconnections between them: a superficial plexus, located just under the arch of the aorta; and a deep plexus, located anterior to and at the bifurcation of the trachea. Both plexuses send nerve fibers that follow the coronary arteries to their respective anterior and posterior locations on the heart. Sympathetic fibers dominate the plexus and carry with them those visceral sensory fibers that are considered responsible for referred cardiac pain--damage to, or altered stimulation of which may lead to profound changes...