Cardiac Cycle

CHRISTY GEO THOMAS

ROLL NO 35
 Basic anatomy of Heart
 Hollow muscular organ situated in the mediastinum left side of thoracic cavity, enclosed
in the pericardium.
 Shape: conical
 Length : 12 cm
 Width : 9 cm
 Weight : 350gm in males & 300gm in females
 4 chambers : right atrium, right ventricle, left atrium, left ventricle.
 Communication between right atrium and ventricle : right AV orifice
 Communication between left atrium and ventricle : left AV orifice
 Valves
A) pair of AV valves : tricuspid valve , bicuspid (mitral) valve.
B) pair of semilunar valves: pulmonary & aortic semilunar valves
 Functions:
 Prevent backward regurgitation of blood
 Facilitate ejection of blood
 Measurements :
Mitral valve : 4 to 6 sq cm
Tricuspid valve : 2.5 Sq cm
Circulation of blood
 2 muscular pumps, right and left pump
 Right pump: right atrium and ventricle
 Left pump: left atrium and ventricle

 Right ventricular pressure : 25 mm hg

 Left ventricular pressure: 120 mm hg

 Right atrial pressure: 8 mm hg

 Left atrial pressure: 12 mm hg
 CARDIAC CONDUCTING SYSTEM
Overview of heart conduction
 SA NODEAV NODEBUNDLE OF HISRT&LT AV BUNDLEPURKINJE
FIBERS
 CARDIAC CONDUCTING SYSTEM
SINOATRIAL NODE (SA NODE/NODE OF KEITH FLACK)
 Small horseshoe shaped specialised myocardial fibers situated in the wall of the right
atrium just below the opening of superior vena cava (SVC)
 It is called as the pacemaker of heart and it initiates the contraction of cardiac muscle by
generating impulse(about 120 impulses/minute)

ATRIOVENTRICULAR NODE (AV NODE/NODE OF TAWARA)

 Located in the right atrium above the tricuspid valve near the opening of coronary sinus
 It conducts the cardiac impulse to the ventricle via the AV Bundle
ATRIOVENTRICULAR BUNDLE (AV BUNDLE/BUNDLE OF HIS)
 It begins from AV node and runs along the inferior part of the membranous part of the
interventricular septum at this point it divides into 2 the right and left bundle branches
 Right bundle branch: conducts the impulse to the purkinje fibers of the right ventricle
 Left bundle branch: conducts the impulse to the purkinje fibers of the left ventricle

PURKINJE FIBERS
 Network of specialised cells, they are abundant with glycogen and have extensive gap
junctions
 Physiology of cardiac cycle
 It is defined as the sequence of electrical and mechanical events occurring between the
beginning of one heart beat.
 Duration: 0.8 sec when heart rate is 75. systolic 0.27sec, diastolic: 0.5 sec
 Stroke volume: 80 ml per beat
 Cardiac output: 5.2 L
 3 phases of cardiac cycle
Atrial systole
Ventricular diastole
Ventricular systole
Atrial systole
 Duration-about 0.1sec
 Blood from the atrium enters the ventricles due to atrial contraction and completes
ventricular filling
 Normally 80% of the blood from atrium reaches the ventricles passively
 Remaining 20% is due to the effect of the contraction.
 In conditions like tachycardia duration of ventricular contraction is lowered .in such
conditions atrial contractions have greater importance in ventricular filling.
 It begins with the contraction of atrium and ends with closing mitral valve.
 It begins with the peak of P wave and ends with the peak of QRS complex in ECG
 There is increased ventricular filling
 Ventricular volume is increased
 Atrial pressure is increased due to atrial contraction, which is responsible for the
generation of ‘a’ wave in JVP
 Mitral valve closes at the end of atrial systole
 Ventricular systole
Ventricular systole is the interval between the closing of the AV valves and the closure of
semilunar valves
 Phase of Isovolumetric contraction
 Phase of ventricular ejection
a) Rapid ejection phase
b) Reduced ejection phase
A) Phase of isovolumetric contraction
 Begins with the closure of mitral valve
 Ends with the opening of aortic valve
 Starts with the peak of QRS complex in ECG
 1st heart sound heard
 No change in the ventricular volume (ventricular size) throughout this phase
B) Phase of ventricular ejection
 1) Phase of rapid ejection
 Onset is marked by the opening of aortic valve
 Aortic valve opens > aortic blood flow increases abruptly > blood is forcefully ejected
from ventricles into aorta. Similarly blood ejects from right ventricles into pulmonary
artery .
 Ventricular pressure increases abruptly from 0 to 80 mm hg in left ventricle and 0 to 8
mm hg in right ventricle.
 Ventricular volume decreased due to emptying of blood into aorta
 Aortic pressure is increased due to blood flow (less than ventricular pressure)
 Aortic blood flow is increased
 Initially there is a fall in the aortic pressure and then it increases gradually.
 The bulging of the closed tricuspid valve into the atrium is responsible for the ‘c’
wave in the JVP at this phase.
 This phase corresponds to ST segment in ECG
2) Reduced ejection phase
 Begins when aortic pressure>ventricular pressure
 Blood continues to flow from ventricles to aorta due to momentum of forward flow of
blood caused during the rapid ejection phase which keeps the aortic valve open.
 Both the aortic and ventricular pressure decreases in this phase
 Ventricular volume is further decreased
 Aortic blood flow decreases
 Atrial pressure continues to increase as blood fills the atrium
 It is marked as the T wave of ECG
 Ends with closure of aortic valve.
Atrial diastole
 Follows atrial systole
 It occurs during ventricular systole
 Atrial diastole is usually merged with Ventricular systole.
Ventricular diastole
 Phase of isovolumetric relaxation.
 Phase of ventricular filling
a)Phase of rapid filling
b)Phase of reduced filling – diastolic
A) Phase of isovolumetric relaxation
 Begins with the closure of aortic valve . And ends with the opening of mitral valve
 Phase in which ventricles starts relaxing
 There is fall in the ventricular pressure
 No change in the ventricular volume
 No aortic blood flow
 2nd heart sound is heard in this phase due to closure of aortic valve (1st half of this
phase)
1)Rapid filling phase
 Begins with the opening of mitral valve
 Blood that has accumulated in the atrium during the ventricular systole rapidly enters
ventricles as soon as the AV valve opens
 Majority 80 % of ventricular filling occurs in this phase.
 Increase in ventricular volume
 Increase in ventricular filling
 Decrease in ventricular and atrial pressure initially.
 3rd heart sound is produced during this phase due to the inrush of blood into the
ventricles
 V wave of JVP is in this phase due to the rise in the pressure in the right atrium as
venous return continues while tricuspid valve remains closed.
 2)Reduced filling-Diastasis
 Slower filling of the ventricles
 Slow rise in the ventricular volume
 No change in the atrial and venous pressure
 It is marked in the ECG as beginning of P wave at the end of the phase.
END DIASTOLIC VOLUME:
 Volume of blood present in each ventricle at the end of ventricular diastole is called as
EDV or preload, which is about 120-130 ml

STROKE VOLUME:
 Volume of blood ejected by each ventricle during each ventricular systole is called
stroke volume it is about 80 ml

END SYSTOLIC VOLUME:

 Volume of blood present in each ventricle at the end of ventricular systole is called end
systolic volume it is about 50-60 ml
Pressure volume relationship in cardiac
cycle (Left ventricle)
Jugular Venous Pressure
 Pressure changes in the atrium is directly reflected in internal jugular vein.
 5 waves , 3 positive waves and 2 negative waves
 Positive waves
a wave : due atrial contraction
c wave : due to bulging of closed tricuspid valve into atrium
v wave : indicates passive rise in pressure in the right atrium as venous return continues
while tricuspid valve is closed
 Negative wave
x descent : due to fall of right atrial pressure due to right atrium relaxation
y descent : due to fall in the right atrial pressure when blood enters into ventricles as
tricuspid valve opens
Thank you