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Cardiac cycle

Learning objectives

Phases of cardiac cycle

Pressure changes

Volume changes

Heart sounds & Its correlation with ECG


Definition

The cardiac events that occur from the beginning of one


heartbeat to the beginning of the next are called the
cardiac cycle
Duration of cardiac cycle
0.8s

Ventricular systole Ventricular diastole

0.3s 0.5s
Phases of cardiac cycle
Atrial cycle Ventricular cycle
1. VENTRICULAR SYSTOLE
1. Atrial systole Isovolumic contraction
Phase of ventricular ejection
2. VENTRICULAR DIASTOLE
2. Atrial diastole
Protodiastole
Isovolumic relaxation
Rapid passive filling
Reduced filling & diastasis
Atrial cycle(0.8s)
Atrial systole
DURATION – 0.1s
Filling of both the atria

Opening of AV valves

75% of flow to ventricles is passive

25% by atrial contraction


Increased intra atrial pressure by 4-6mmhg
Atrial diastole (0.7s)

Coincides with ventricular systole

Atrial muscles relax

Gradual filling of atria due to venous return

pressure gradually increases


Ventricular cycle(0.8s)
Ventricular systole( 0.3s)

1. Phase of iso volumic contraction (0.05s)

2. Phase of ventricular ejection

- Rapid ejection (0.1s)


- Slow ejection (0.15s)
Phase of iso volumic contraction(0.05s)
Ventricular filling

ventricle pressure exceeds atrial pressure

A-V valve closes ( HS1)

ventricular pressure gradually increases, as semilunar valves are closed

Volume of blood in ventricles remains same


When left ventricle pressure crosses more than aortic
pressure - aortic valve opens

When right ventricle pressure crosses more than pulmonary


pressure - pulmonary valve opens
Phase of ventricular ejection(0.25s)
Rapid ejection phase(0.1s)

Semilunar valves open

2/3rd of stroke volume is ejected

Pressure in LV – 120mmHg, RV -25mmHg

RV ejection begins before LV & continues even after


Slow ejection phase ( 0.15s)

About 1/3rd of stroke volume is ejected

Intra ventricular pressure starts declining but not less than


aorta or pulmonary artery
Ventricular distole( 0.5s)
1. Protodiastole (0.04s)

2. Phase of isovolumic relaxation (0.05s)

3. Rapid passive filling phase(0.11s)

4. Reduced rapid filling(0.19s)

5. Last rapid filling phase (0.1s)


Protodiastole (0.04s)

End of ventricular systole

ventricles relax & intraventricular pressure decreases

Closure of semilunar valves (HS2)


Phase of isovolumic relaxation (0.05s)
After closure of semilunar valves

Even AV valves closed so ventricles relax as closed chambers

Volume remains same , pressure decreases (from 80 to 3mmhg) in LV

Phase ends when AV valves open


Rapid passive filling phase(0.11s)

After AV valves open

Rapid flow of blood from atria to ventricles


(75%)
Reduced rapid filling(0.19s)

Pressure gradient b/w atria & ventricles reduces

decreases rate of flow from atria to ventricles

Slow filling of ventricles


Last rapid filling phase (0.1s)

Coincides with atrial systole

Atrium contracts , AV valves opens & blood flows to


ventricles(25%)
Events in cardiac cycle
Events in Cardiac cycle
Pressure changes in ventricles

Pressure changes in atria

Pressure changes in aorta

Pressure changes in pulmonary artery


Pressure changes in ventricles

DURING ATRIAL SYSTOLE

Slight increase in intra ventricular pressure

6-7 mmHg in RV & 7-8mmHg in LV


AB – atrial systole
BC – iso volumic contraction
C –opening of semilunar CD-
valves
rapid eject

EF – protodiastole
DE- slow ejection GH – rapid filling
FG – isovolumic relaxation
During ventricular systole
During iso volumic contraction

Pressure gradually increases

During rapid ejection phase

Pressure rises to maximum 120mmhg(lv) & 25mmhg (rv)


AB – atrial systole
BC – iso volumic contraction
C –opening of semilunar CD-
valves
rapid eject

EF – protodiastole
DE- slow ejection GH – rapid filling
FG – isovolumic relaxation
During slow ejection

❑There is no further ventricular contraction

❑Pressure starts declining


AB – atrial systole
BC – iso volumic contraction
C –opening of semilunar CD-
valves
rapid eject

EF – protodiastole
DE- slow ejection GH – rapid filling
FG – isovolumic relaxation
During ventricular diastole
Protodiastole

Intraventricular pressure drops rapidly as ventricles relaxing

Pressure is below aorta & pulmonary artery

Semilunar valves are closed (HS2)


x y

AB – atrial systole
BC – iso volumic contraction
C –opening of semilunar CD-
valves
rapid eject

EF – protodiastole
DE- slow ejection GH – rapid filling
FG – isovolumic relaxation
Jugular venous pressure(JVP) curve
a – Atrial systole

c – ventricular contraction

X – fall in atrial pressure due to


atrial relaxation

v- venous filling

Y- fall in atrial pressure due to


opening of AV valves
Pressure changes in atria

During atrial systole ( a wave )

Sharp rise in intra atrial pressure (4-6mmHg in RA & 7-8 mmHg in LA)

At the end of atrial systole pressure drops to baseline


During ventricular systole (c wave )
Iso volumic contraction

Sharp rise in atrial pressure due to ventricle contraction

Bulging of AV valves in to atria


Ventricular ejection

Ventricles contract

Pull AV fibrous ring downwards

Intra atrial lumen diameter increases

Intra atrial pressure drops sharply ( x descent )


During atrial diastole( v wave )

Increased venous filling from SVC &IVC

Pressure in right atrium


When pressure in right atrium more
than ventricle

Tricuspid valve will open

Pressure in Right atrium( y descent )


Jugular venous pressure(JVP) curve
a – Atrial systole

c – ventricular contraction

X – fall in atrial pressure due to atrial


relaxation during ventricular systole

v- venous filling

Y- fall in atrial pressure due to


opening of AV valves
AB – atrial systole
BC – iso volumic contraction
C –opening of semilunar CD-
valves
rapid eject

EF – protodiastole
DE- slow ejection GH – rapid filling
FG – isovolumic relaxation
AORTIC PRESSURE CHANGES
III

IV
Pressure volume loop

II

I
Phase I: Period of filling A -B

Phase II: Period of B-C


isovolumic contraction

Phase III: Period of C-D


ejection

Period of isovolumic D-A


relaxation
SEMINAR ROOM ALLOCATION
1-38 – lecture hall
39 – 75 – Biochemistry demo
76- 112 – Anatomy demo
113 – 150 – Physio demo 1
THANK YOU
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