1. cvs module phase II MBBS 2007- 2008 CARDIAC CYCLE PHYSIOLOGY CARDIOVASCULAR MODULE PHASE II 2007-2008

2. cvs module phase II MBBS 2007- 2008 INSTRUCTOR INFORMATION Dr AZRA KIRMANI ASSISTANT PROFESSOR DEPARTMENT OF PHYSIOLOGY ROOM NO 951/1 FIRST FLOOR BUILDING 9 EXT- 24306 MOBIL- 0501639346, RESIDENCE - 6022433

3. cvs module phase II MBBS 2007- 2008

4. Events of the cardiac cycle at a heart rate of 75 beats/min Ventricular Diastole 0.5 seconds Ventricular Systole 0.3 seconds Atrial systole 0.1 second Atrial Systole 0.7 seconds

5. cvs module phase II MBBS 2007- 2008 Late Diastole

6. cvs module phase II MBBS 2007- 2008 Atrial Systole

7. cvs module phase II MBBS 2007- 2008 Atrial Systole

8. cvs module phase II MBBS 2007- 2008 ATRIAL SYSTOLE ECG

9. cvs module phase II MBBS 2007- 2008 ATRIAL SYSTOLE Heart Sounds

10. cvs module phase II MBBS 2007- 2008 Atrial systole contributes 30% 0f ventricular filling. The end diastolic ventricular volume is 130ml.

11. cvs module phase II MBBS 2007- 2008 Isovolumetric ventricular contraction

12. cvs module phase II MBBS 2007- 2008 ISOVOLUMETRIC CONTRACTION ECG

13. cvs module phase II MBBS 2007- 2008 ISOVOLUMETRIC CONTRACTION Heart Sounds

14. cvs module phase II MBBS 2007- 2008 Ventricular Ejection

15. cvs module phase II MBBS 2007- 2008 RAPID EJECTION Pressures & Volumes

16. cvs module phase II MBBS 2007- 2008 RAPID EJECTION ECG

17. cvs module phase II MBBS 2007- 2008 RAPID EJECTION Heart Sounds

18. cvs module phase II MBBS 2007- 2008 REDUCED EJECTION Late in systole, the aortic pressure actually exceeds the ventricular, but for a short period momentum keeps the blood moving forward.

19. cvs module phase II MBBS 2007- 2008 REDUCED EJECTION Heart Sounds

20. cvs module phase II MBBS 2007- 2008 PROTODIASTOLE Once the ventricular muscle is fully contracted, the already falling ventricular pressures drop more rapidly. This is the period of protodiastole. It lasts about 0.04 s. It ends when the momentum of the ejected blood is overcome and the aortic and pulmonary valves close, setting up transient vibrations in the blood and blood vessel walls.

21. cvs module phase II MBBS 2007- 2008 The amount of blood ejected by each ventricle per stroke at rest is 70-90 mL. The end-diastolic ventricular volume is about 130 mL. Thus, about 50 mL of blood remains in each ventricle at the end of systole (end- systolic ventricular volume). The ejection fraction, the percent of the end-diastolic ventricular volume that is ejected with each stroke, is about 65%. The ejection fraction is a valuable index of ventricular function.

22. cvs module phase II MBBS 2007- 2008 Isovolumetric ventricular relaxation

23. cvs module phase II MBBS 2007- 2008 ISOVOLUMETRIC RELAXATION

24. cvs module phase II MBBS 2007- 2008 ISOVOLUMETRIC RELAXATION ECG

25. cvs module phase II MBBS 2007- 2008 ISOVOLUMETRIC RELAXATION Heart Sounds

26. cvs module phase II MBBS 2007- 2008 RAPID VENTRICULAR FILLING Heart

27. cvs module phase II MBBS 2007- 2008 RAPID VENTRICULAR FILLING Pressures & Volumes

28. cvs module phase II MBBS 2007- 2008 RAPID VENTRICULAR FILLING ECG

29. cvs module phase II MBBS 2007- 2008 RAPID VENTRICULAR FILLING Heart Sounds

30. cvs module phase II MBBS 2007- 2008 REDUCED VENTRICULAR FILLING Pressures & Volumes

31. cvs module phase II MBBS 2007- 2008 REDUCED VENTRICULAR FILLING ECG

32. cvs module phase II MBBS 2007- 2008 REDUCED VENTRICULAR FILLING Heart Sounds

33. cvs module phase II MBBS 2007- 2008

35. Events of the cardiac cycle at a heart rate of 75 beats/min 1, atrial systole; 2, isovolumetric ventricular contraction; 3, ventricular ejection; –Rapid ejection –Slow ejection –Protodiastole 4, isovolumetric ventricular relaxation; 5, ventricular filling.

36. cvs module phase II MBBS 2007- 2008 Note that late in systole, aortic pressure actually exceeds left ventricular pressure. However, the momentum of the blood keeps it flowing out of the ventricle for a short period.

37. cvs module phase II MBBS 2007- 2008

39. Right Ventricular & Pulmonary Arterial Pressure

40. cvs module phase II MBBS 2007- 2008

43. Pressure Volume Relationship