The heart is generally perceived as the core of emotion, affection, and love. Its universally accepted iconic representation is everywhere these sentiments have to be depicted. However, the question is: where does the popular heart shape comes from? In fact, it is difficult to relate this symbol to the real heart shape. With possible early examples or direct predecessors in the 13th to 14th century, the familiar symbol of the heart representing love developed in the 15th century, and became popular in Europe during the 16th. While performing several coronary total occlusion recanalization procedures, it has become excitingly evident that, during contemporaneous dual injections of both right and left coronary arteries, the iconic shadow of the heart can be effectively observed. The possibility that the evidence of this cardiac shape could already be visible to the eyes of people living at the time of the first iconic appearances of the heart image is difficult to surmise. How could our ancestors connect the iconic form to the real heart shape? In the present article, we discuss how this iconic shape could have been derived from anatomical observations made in the ancient world.
