A detailed nonlinear four-region (red blood cell, plasma, interstitial fluid, and parenchymal cell) axially distributed convection-diffusion-permeation-reaction-binding computational model is developed to study the simultaneous transport and exchange of oxygen (O 2 ) and carbon dioxide (CO 2 ) in the blood-tissue exchange system of the heart. Since the pH variation in blood and tissue influences the transport and exchange of O 2 and CO 2 (Bohr and Haldane effects), and since most CO 2 is transported as (bicarbonate) via the CO 2 hydration (buffering) reaction, the transport and exchange of and H + are also simulated along with that of O 2 and CO 2 . Furthermore, the model accounts for the competitive nonlinear binding of O 2 and CO 2 with the hemoglobin inside the red blood cells (nonlinear O 2 -CO 2 interactions, Bohr and Haldane effects), and myoglobin-facilitated transport of O 2 inside the parenchymal cells. The consumption of O 2 through cytochrome-c oxidase reaction inside the parenchymal cells is based on MichaelisMenten kinetics. The corresponding production of CO 2 is determined by respiratory quotient (RQ), depending on the relative consumption of carbohydrate, protein, and fat. The model gives a physiologically realistic description of O 2 transport and metabolism in the microcirculation of the heart. Furthermore, because model solutions for tracer transients and steady states can be computed highly efficiently, this model may be the preferred vehicle for routine data analysis where repetitive solutions and parameter optimization are required, as is the case in PET imaging for estimating myocardial O 2 consumption.