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The endocardium does not allow the passage of O2 and other nutrients to the myocardium because of the watertight endothelium. Additionally, the myocardium is too thick for diffusion to take place across the cells. Therefore another alternative is required.

Generally, in order for any type of tissue to receive and eliminate nutrients and waste products (respectively) the blood must be in small pressure so osmosis can take place efficiently. The blood that passes through the atria and ventricles has very large pressure in order to reach all parts of the body. Therefore, small blood vessels called coronary arteries branch from the aorta (oxygen-rich) and move though the heart muscle. These vessels make sure that the blood passes through very slowly and during the diastole of the heart the cardiomyocytes receive their nutrients.

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