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The Cardiac Cycle: Overview

Cardiac cycle components
Changes within heart from one heartbeat to the next Systole
contraction of a heart chamber

The Cardiac Cycle: Overview

Pressure changes in cardiac cycle
Alternating contraction and relaxation of atria and ventricles Pressure increase during contraction Pressure decrease during relaxation Responsible for unidirectional movement of blood through chambers
blood moving along pressure gradient

Diastole
relaxation of the heart chamber

Responsible for opening and closing of heart valves

ensures blood moves in a forward direction

The Cardiac Cycle: Overview

Pressure changes in cardiac cycle (continued)
Ventricular contraction
causes ventricular pressure to rise AV valves pushed and kept closed (preventing backflow) semilunar valves pushed open force blood from ventricle into arterial trunk

The Cardiac Cycle: Overview

Pressure changes in cardiac cycle (continued)
Ventricular relaxation
causes ventricular pressure to decrease closure of semilunar valves
pressure no longer pushing them open

AV valves open
pressure no longer pushing them closed

The Cardiac Cycle: Overview Pressure changes that occur during the cardiac cycle are responsible for what two physiologic processes within the heart?
Unidirectional movement of blood through heart; opening and closing of heart valves

The Cardiac Cycle: Events

As the Cardiac Cycle Begins
Four chambers at rest Blood returning to right atrium and to left atrium Passive filling of ventricles AV valves open Atrial pressure > ventricular pressure Semilunar valves closed Pressure in ventricles < arterial trunk pressure

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The Cardiac Cycle: Events

Atrial Systole (1)
Atria contracted and ventricles relaxed Moves remaining blood from atria to ventricles Ventricular pressure < atrial pressure Ventricular pressure < arterial trunk pressure AV valves open Semilunar valves closed Ventricles at maximum blood volume
end-diastolic volume (EDV) in ventricle

The Cardiac Cycle: Events

Early Ventricular Systole (2)
Beginning of ventricular contraction
moves blood into arterial trunks

Atria relaxed and ventricles contracted Ventricular pressure > atrial pressure Ventricular pressure < arterial trunk pressure AV valves and semilunar valves closed Isovolumetric contraction

The Cardiac Cycle: Events

Late Ventricular Systole (3)
Atria relaxed and ventricles contracted Ventricular pressure > atrial pressure Ventricular pressure > arterial trunk pressure AV valves closed Semilunar valves open

The Cardiac Cycle: Events

Late Ventricular Systole (3) (continued)
Blood ejection termed ventricular ejection Amount of blood, stroke volume (SV) Some blood remaining in ventricle
end-systolic volume (ESV)

ESV = EDV - SV

The Cardiac Cycle: Events

Early Ventricular Diastole (4)
Atria relaxed and ventricles relaxed Ventricular pressure > atrial pressure Ventricular pressure < arterial trunk pressure AV valves closed

The Cardiac Cycle: Events

Late Ventricular Diastole (5)
Start of ventricular filling Atria relaxed and ventricles relaxed Ventricular pressure < atrial pressure
forces open AV valve

Blood flowing backward slightly caught in semilunar valves, which close Prevents backflow into ventricles Isovolumetric relaxation

Ventricular pressure < arterial trunk pressure Semilunar valves closed When most ventricular filling occurs

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Figure 19.21
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Figure 19.22a-b
2 Early ventricular systole 3 Late ventricular systole

1 Atrial systole

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
SV AV valves closed Semilunar valves open

(a) ECG
Initiates contraction of ventricles R Initiates contraction of atria P Q

Atria contract

Atria relax

Ventricles contract Chambers Ventricular pressure Valves Atria contract Ventricles relax < Atrial pressure < Arterial trunk pressure AV valves open Semilunar valves closed Chambers Ventricular pressure Valves Atria relax Ventricles contract

EDV

Ventricles contract Chambers Ventricular pressure Valves Atria relax Ventricles contract > Atrial pressure > Arterial trunk pressure AV valves closed Semilunar valves open

ECG is a graphic recording of electrical changes in the heart that initiate atrial and ventricular contraction T

> Atrial pressure < Arterial trunk pressure AV valves closed Semilunar valves closed

5 Late ventricular diastole

4 Early ventricular diastole

(b) Chambers
1
AV valves open Ventricles relax Chambers Ventricular pressure Valves Atria relax Ventricles relax < Atrial pressure < Arterial trunk pressure AV valves open Semilunar valves closed Chambers Ventricular pressure Valves Atria relax Ventricles relax > Atrial pressure < Arterial trunk pressure AV valves closed Semilunar valves closed
SV: Stroke volume EDV: End diastolic volume ESV: End systolic volume

4 Relax

Semilunar valves closed ESV

Atria Ventricles

Relax

Contract Relax Contract

Relax

Figure 19.22c

Figure 19.22d-e

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

(d) Heart valves

AV Semilunar Open Closed Closed Open Open Closed

(c) Pressure in left atrium, left ventricle, and aorta

120 Dicrotic notch* Pressure (mm Hg)

(e) Blood volume in left ventricle

80 Ventricular volume (mL) Aorta End diastolic volume (EDV) 130 Stroke volume (SV) 100 End systolic volume (ESV) 0 0.2 0.4 Time (msec) 0.6 0.8

40

Left Atrium

Left Ventricle

70

Cardiac Output
Clinical View: Heart Sounds and Heart Murmurs
Four normal heart sounds
two familiar sounds, lubb-dupp, S1 and S2 S1, closing of AV valves S2, closing of semilunar valves two minor sounds, S3 and S4 provide clinically important information about heart and valves

Cardiac Output
Clinical View: Heart Sounds and Heart Murmurs (continued)
Heart murmur
abnormal heart sound result of turbulence of blood passing through heart some medically important, some not two types:
valvular insufficiency and valvular stenosis

Each valve heard best at specific anatomic locations