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We present the first large-scale simulation of blood flow in the coronary artieries and other vessels supplying blood to the heart muscle, with a realistic description of human arterial geometry at spatial resolutions from centimeters down to 10 microns (near the size of red blood cells). This multiscale simulation resolves the fluid into a billion volume units, embedded in a bounding space of 300 billion voxels, coupled with the concurrent motion of 300 million red blood cells, which interact with one another and with the surrounding fluid. The level of detail is sufficient to describe phenomena of potential physiological and clinical significance, such as the development of atherosclerotic plaques. The simulation achieves excellent scalability on up to 294, 912 Blue Gene/P computational cores.