Where is the heart located?

When you understand where heart is located in your chest, it will help you learn more about heart diseases and how they affect you. I will be explaining the details of location and structure of the human heart in plain English without using any technical jargon. In my medical practice, I come across many patients with different types of heart disease and many of them have questions about human heart. I am writing this article to explain the basic facts about your heart and how it relates to your heart symptoms. However, knowing the location of heart is not enough if you are worried about a heart attack. Please read this article about symptoms of heart attack in general or this article about mini heart attack symptoms or this article about silent heart attacks if you are worried about those things.

Where is the heart located in relation to your chest wall?

When you talk about the location of any organ in your body, you need to define some landmarks first. Heart is located inside your chest wall. It is important to look at your chest wall and pinpoint some specific areas that we will use as reference point when we talk about the exact location of your heart.

location of the heart sternal notch
location of the heart sternal notch

When you look in a mirror, look slightly below your neck. You will see a small dip where your neck meets your chest. This is an important landmark. It is called the sternal notch. It is the point where your 2 collarbones meet your central breastbone. You can feel your two collarbones going towards your shoulders from this point. If you feel slightly below this notch along your breastbone, you will feel a ridge in the midline. This ridge is called the sternal angle. It is another important chest landmark that will help you find out the exact location of your heart.

Where is the heart located from sternal angle
Where is the heart located from sternal angle

Your heart in protected inside your chest by your rib cage. Your ribs form the rib cage by connecting with your spine in the back and breast bone in the front. To understand where different parts of your heart are located inside your heart, you need to be able to locate and count your front ribs. You cannot see or feel your first ribs because they hide deep behind your collarbones. However, you can easily feel your second ribs and use them to count and locate other ribs. When you locate the ridge in the breastbone( the sternal angle), you can simply move your finger to the left or the right and you will be directly touching your second rib. From this point on you can feel and count the rest of your ribs as you move your finger downwards.

To understand the detailed location of your heart, you need to count downward as far as the 6th rib.

Where is your heart located in relation to your ribs, breastbone and collarbones?

Where is the heart located in rib case
Where is the heart located in rib case

Now that you know what makes the front of your chest wall, you can ask more specific question about the exact location of your heart. If you look at the picture, you can identify the four borders and one pointed tip or apex of the projection of your heart inside your chest. The upper border starts at the level of the 2nd rib about ½ inch to the left of the edge of the breastbone. The upper boarder is slanted downwards towards the right. The upper border and the right border of the heart meet at a point on the third rib ½ inch to the right of the right breastbone edge. The lower border of the heart meets the right border at a point on the sixth rib ½ inch to the right of the right edge of the breastbone. The left border of the heart is angled towards the left as it goes downwards. The point where the left border of the heart meets the lower border of the heart is the leftmost point of the heart. It called the apex of the heart. The apex of the heart is located at a point in between the fifth and the sixth left ribs. It is at a distance of about 3 and a ½ inch from the center of the heart. You may be able feel the beating at the apex of your heart if you have relatively thin chest wall. First, you can try to feel the pulsation by putting the flat of your hand in that area. Once you feel it, you can narrow its location by using two fingers and moving them where the impulse is greatest. Where are the different chambers of the heart located? Now that you know where the borders of your heart lie inside your chest, lets try and look at the locations of the different chambers of the heart.

location of the heart chambers
location of the heart chambers

The heart is made up of 4 chambers. The upper chambers are called atria (singular atrium) and the lower chambers are called ventricles. There are right and left atria, and right and left ventricles. The left side is bigger and more muscular than the left side. The shape of the heart in not symmetrical and, therefore, the right and the left sides are not located along the right and left borders. You need to take into account the 3 dimensional nature of the heart to understand how the different chambers project when looking through the front of the chest. When looking at the heart from the front, the right border of the heart is formed entirely by the right atrium. Right and left ventricles form the lower border of the heart. The left ventricle forms the apex of the heart. The left atrium forms the small upper portion of the left heart border. The left ventricle forms the rest of the left heart border. The majority of the left atrium lies on the back of the heart.

 

The location of the heart chambers and its relation to blood flow

Location of the heart chambers and its relation to blood flow
Location of the heart chambers and its relation to blood flow

Knowledge about the location of the heart chambers will hell you understand how blood flows in and out of the heart. First, the used blood from the body returns to the right upper chamber (called right atrium). It then flows to the right lower chamber (called the right ventricle). The right ventricle pumps the blood to the lungs. The lungs freshen up the blood with oxygen and send it back to the left upper chamber (called the left atrium). The blood then flows down to the left lower chamber (called the left ventricle). The left ventricle has the most powerful pump and it pumps out the fresh blood to the rest of the body.

Nerve supply of the heart:

To understand your heart symptoms, you need to answer 2 questions: “Where is heart located?” and “What is the nerve supply of the heart?”. Knowing the location of the heart and its different chambers are important but it is not enough to understand how you feel pain or discomfort coming from the heart. It is important to note that the heart does not have the kind of pain sensing nerve that are present on your chest wall. The nerve supply of the heart is a part of the autonomic nervous system and it normally bypasses the conscious part of your brain. That is why you do not normally feel your heart beating. You do not feel direct pain from your heart. The pains you feel from abnormalities in your heart do not match the location of your heart in your chest. Pain resulting from a lack of blood supply in your heart originates from a complex process and such pain is poorly localizing. The pain may even be not be felt in your chest at all.

Why does the location of the heart matter if you cannot relate the pain to the location?

If you can pinpoint the exact location of your chest pain, that pain is likely coming from somewhere other than your heart. The knowledge about the exact location of your heart inside your chest helps your doctor listen to your heart and analyze normal and abnormal heart sounds coming from different parts of your heart. Detailed knowledge of the exact location of your heart is absolutely necessary to interpret x-rays of your chest. The normal location and size of your heart chambers serve as a reference when part of your heart changes in shape or size from certain medical conditions. You may also feel your heart beat at the apex of your heart when your heart is beating too fast or too forcefully. If your heart is enlarged, the apex of your heart may be felt farther to the left instead of the normal location. An abnormal apical beat may be the first sign that the shape, size and location of your heart is not normal. An ultrasound of your heart can enable your heart doctor to see how your heart chambers look. The knowledge of normal location and size of your heart is essential to interpret any abnormal findings.

I encourage you to share this article with anyone who is curious about the location of the heart. It is my hope that this article will help you understand some basic facts about your heart. If you have any more questions about the heart or heart diseases, please ask them in the comments below. I cannot give you any specific medical advice but I can help you understand basic facts about the human heart and heart diseases.