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The endocardium underlies the much more voluminous myocardium, the muscular tissue responsible for the contraction of the heart. The outer layer of the heart is termed epicardium and the heart is surrounded by a small amount of fluid enclosed by a fibrous sac called the pericardium. [2]
The inner endocardium lines the cardiac chambers, covers the cardiac valves, and joins with the endothelium that lines the blood vessels that connect to the heart. On the outer aspect of the myocardium is the epicardium which forms part of the pericardial sac that surrounds, protects, and lubricates the heart. [1]
The heart wall is made up of three layers: the inner endocardium, middle myocardium and outer epicardium. These are surrounded by a double-membraned sac called the pericardium. The innermost layer of the heart is called the endocardium. It is made up of a lining of simple squamous epithelium and covers heart chambers and valves.
[2] The conduction system consists of specialized heart muscle cells, situated within the myocardium. [3] There is a skeleton of fibrous tissue that surrounds the conduction system which can be seen on an ECG. Dysfunction of the conduction system can cause irregular heart rhythms including rhythms that are too fast or too slow.
Days 1-3 are marked by “acute inflammation”, in which neutrophils infiltrate the ischemic tissue. A major complication during this period is fibrinous pericarditis, particularly in transmural ventricular wall damage (an infarct that impacted all 3 layers of the heart, the epicardium, myocardium, and endocardium).
These categories are called epicardial (above the epicardium, or the outermost tissue of the heart) and microvascular (close to the endocardium, or the innermost tissue of the heart). [ 2 ] Reduced function of the coronary arteries can lead to decreased flow of oxygen and nutrients to the heart.
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Whatever the case, the heart needs blood, and if we look at the heart wall, there’s three layers—the outermost layer, the epicardium, then the myocardium in the middle, and the endocardium inside the heart. The coronary arteries start up in the epicardium, and then dive down and supply all the heart tissue.