The description of the “Valentine” orientation of the heart

Excerpt

We read with interest the recent article by Oztuk et al. [4] and use this article merely as an example of widespread terminology usage. The basis for description of any structure within the body is that it should be described relative to the so-called anatomical position. The key to this approach, which has stood the text of centuries of anatomical teaching, is that the components of organs are described as they lie within the body. Sadly, those describing the components of the heart, ourselves included, until very recently, have continuously flouted this well-respected convention. Thus, examination of any textbook of anatomy will show that, almost without exception, the heart is described as though standing on its apex, in the so-called Valentine position [2] rather than naming its components as they relate to the adjacent thoracic organs or to the upright posture. Until relatively recently, clinicians have slavishly followed this pattern. Although the diaphragmatic surface of the heart is correctly described as being inferior, the artery that courses along this surface is said to be the posterior descending coronary artery. It is questionable whether this artery should be described as descending as it runs horizontally toward the ventricular apex, but it is clearly positioned inferiorly rather than posteriorly [1]. Under no circumstances can the artery sensibly be said to be posterior and descending. Yet, in virtually all anatomic textbooks, along with texts devoted to clinical cardiology, the structure is described as the posterior descending coronary artery. In fact, the only posterior structure of the heart is the left atrium. …