The Cardiac Cycle

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The cardiac cycle Describing the sequence of events in one heart beat

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atrio-ventricular valves open atrio-ventricular valves close

atrio-ventricular valves open atrio-ventricular valves close semi-lunar valves open

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The volume of blood pumped by each ventricle per minute is called cardiac output Cardiac output = Stroke Volume X Heart Rate Normal value = 5 Liters /Minute Cardiac output = Stroke Volume X Heart Rate The factors which regulate stroke volume and Heart rate are basically regulating Cardiac output Volume of blood ejected by each ventricle in single systole; Normal Value = 70 ml/beat Stroke Volume = End diastolic Volume – End Systolic Volume So stroke volume is mainly controlled by EDV ESV VENOUS RETURN: What ever blood volume returns to the heart, same is pumped forward through the Frank’s Starlings Law. According to this law 13- 15 liters of blood volume can be pumped out without cardiac stimulation. DURATION OF DIASTOLE OR FILLING TIME: ventricular filling occurs during diastole, so there must be adequate ventricular filling time. DISTENSIBILITY OF THE VENTRICLES: Normally ventricles are distensible to accommodate adequate blood volume. Infarction decreases the distensibility which decreases the EDV. ATRIAL CONTRACTION: There must be adequate atrial contraction to have adequate EDV. If atrial function is not adequate then EDV will decrease. E.S.V is basically CONTROLLED BY MYOCARDIAL CONTRACTION FORCE OF MYOCARDIAL CONTRACTION: It depends upon the initial length of muscle fibers according to frank’s starlings law. PRELOAD: The effect of EDV on initial length is called preload. So EDV also effects the ESV. AFTER LOAD: Force of contraction is also dependant upon the resistance against which the ventricles have to pump CONDITION OF THE MYOCARDIUM : It also effects the force of contraction. AUTONOMIC NERVES : Sympathetic stimulation increases and parasympathetic stimulation decreases force of contraction HORMONES: Catecholamines, thyroxine, glucagon, digitalis, calcium, increased temp, caffeine, theophyline increase the force. Force decreases by hypoxia, acidosis, barniturates, procainamide and quinidine decrease the force of contraction.

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CARDIAC CYCLE, ECG AND HEART SOUNDS: BY Wincy Thirumurugan.. “Cardiac cycle refers to the series of events that take place when the heart beats.” Each cycle is initiated by spontaneous contraction in the SA node and then transmit through the A-V bundle and branches into the ventricles results completion of one cycle. EVENTS OR PHASES OF CARDIAC CYCLE: Diastolic phase (Diastole) in this phase the heart chamber are in the state of relaxation and fills with blood that receives from the veins [IVC, SVC,PULMONARY VEINS] Systolic phase (Systole) in this the heart chambers are contracting and pumps the blood towards the periphery via the arteries. [ Pulmonary artery and aorta] PHASES OF THE CARDIAC CYCLE The different phases of the cardiac cycle involve: Atrial diastole - Atrial relaxation Atrial systole -Atrial contraction Isovolumic relaxation -ventricular relaxation in the early phase but blood will not move and the Atrio ventricular valves will be closed Ventricular filling - ventricular relaxation, the Atrio ventricular valves will be open allows filling blood in the ventricles Isovolumic contraction of ventricle – ventricular systole in the early phase but no movement of the blood. The semilunar valves will be closed. Ventricular ejection -ventricular contraction and send blood out of the ventricles through opened semilunar valves. 6. Ventricular Filling Stage: second phase. Rapid Filling, Slow Filling & Last Rapid Filling Duration of Cardiac Cycle: In a normal person, a heartbeat is 72 beats/minute. An Electrocardiogram (ECG) is a medical test that detects cardiac (heart) abnormalities by measuring the electrical activity generated by the heart as it. The machine that records the patient’s ECG is called an electrocardiograph. contracts. PLACEMENT OF ECG LEADS ECG WAVES: The P wave is caused by spread of depolarization through the atria, After the onset of the P wave, The QRS waves Occurs as a result of electrical depolarization of the ventricles, the ventricular T wave represents the stage of repolarization of the ventricles, The 'U' wave is a wave comes after the T wave of ventricular repolarization and may not always be observed. HEART SOUNDS: First Heart Sound (S1) The first heart sound results from the closing of the mitral and tricuspid valves. Second Heart Sound (S2): The second heart sound is produced by the closure of the aortic and pulmonic valves. Third Heart Sound (S3): The third heart sound, also known as the “ventricular gallop,” occurs just after S2 when the mitral valve opens, allowing passive filling of the left ventricle. The S3 sound is actually produced by the large amount of blood striking a very compliant LV. [Compliance heart means how easily the chamber of heart or the lumen of blood vessels expands when it is filling with the blood] Fourth Heart Sound (S4): The fourth heart sound, also known as the “atrial gallop,” occurs just before S1 when the atria contract to force blood into the LV.

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The Cardiac Cycle

1. The cardiac cycle Describing the sequence of events in one heart beat

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