HEART AS A PUMP

IGB GITA PRANATA PUTRA, MD, FIHA

FACULTY OF MEDICINE AND HEALTH SCIENCE
WARMADEWA UNIVERSITY
 CARDAC OUTPUT
• Cardiac output (CO) = volume of blood
pumped by each ventricle per minute
• During any period, vo of blood flowing
through the pulmonary circulation is the same
as the volume flowing through the systemic
circulation.
• CO determined by HR and SV
• The difference between the cardiac output at
rest and the maximum volume of blood the
heart can pump per minute is called the
cardiac reserve.
 Role of autonomic on heart
• Heart is innervated by both divisions of the
autonomic nervous system
• The vagus nerve, primarily supplies the
atrium, especially the SA and AV nodes.
Parasympathetic innervation of the ventricles
is sparse.
• The cardiac sympathetic nerves also supply
the atria, including the SA and AV nodes, and
richly innervate the ventricles.
 Multiple Factors Influence Stroke
Volume
• Length-Tension Relationships and the Frank-
Starling Law of the Heart longer the muscle
fiber and sarcomere when a contraction
begins, the greater the tension developed, up
to a maximum
• Stroke Volume and Venous Return  EDV
VR determined by contraction or compression
of veins, pressure changes in the abdomen
and thorax, sympathetic innervation of veins.
 What is determine the afterload?
• The combined load of EDV and arterial
resistance during ventricular contraction 
afterload
• Elevated arterial blood pressure and loss of
aorta stretchability (compliance) increase
afterload  LV hyperthrophy
• Functional cardiac index = ejection fraction
 Association of afterload and MAP
• Arterial blood pressure = the driving pressure
created by the pumping action of the heart.
• MAP closely regulated : ensure the blood flow
and not so high
• MAP determined by CO and TPR
• MAP = systolic + 2diastolic
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• THANKS