Examination of the heart

The most common method of examining the heart involves opening each of the four chambers according to the flow of blood. 1'2 Briefly, the right atrium is opened from the inferior vena cava to the tip of the atrial appendage; the right ventricle is opened along its a t t achment to the ventr icular septum from the tricuspid annulus through the pulmonary outflow tract; the left atrium is opened by cutting across the roof of the atrium between the left and right puhnonary veins; and the left ventricle is opened laterally between the interior and posterior papillary muscles to the apex and then cut along the anter ior wall adjacent to the ventricular septum through the aortic outflow tract. The classic method produces an ideal teaching specimen, but it is not optimal for evaluating certain types of pathology in the heart. For example, the location and extent of a myocardial infarction may not be well demonstrated in a specimen opened in this manner . Newer clinical diagnostic imaging techniques and recent concepts of pathophysiology require diverse mettmds of dissection to correlate cardiac anatomy effectively.