Cardiac cycle Flashcards
During a single heart beat, the cardiac cycle consists of what four events
Electrical
Contractile
Pressure
Valvular
2 periods of cardiac cycle
Diastole
Systole
Diastole
Relaxation of heart muscle and refills with blood
Systole
Contraction of heart muscle and pumping of blood
Arterial line
Thin catheter inserted into an artery
Allow to draw blood easily
Blood pressure monitoring and blood tests
Measure SBP,DBP,MAP
Systolic pressure
120mmHg
Diastolic pressure
70mmHg - normally twice as long as systolic pressure at rest
MAP
87mmHg
How do you work out MAP
diastolic pressure + 1/3 of the pulse pressure
Pulse pressure equation
Systolic pressure - diastolic pressure
In cardiac cathertisation what screening tool is used to guide artery
X-ray
Where is a cardiac artery usually inserted
In the groin area
Threaded through vessels - pressure tracing as follows arteries or veins
What does the dicrotic notch represent
Closure of the aortic valve
Which ventricle is circular and thick walled
Left higher pressures
Which ventricle is crescent shaped and thin walled for low pressure
Right ventricle
What muscles anchor mitral valve leaflets
Prominent papillary muscles
In right heart catheterisation where do you enter the catheter
Neck
Sometimes groin
When is pulmonary artery wedge pressure increased
Vasoconstriction Fluid overload Right to left shunt VSD Left ventricular failure Pulmonary hypertension
When is pulmonary artery wedge pressure decreased
Vasodilation and hypovolaemia
Range for right atrial pressure
What is this equivalent to and seen clinically where
6/2
Central venous pressure
Jugular venous pressure
Pulmonary artery pressures
25/10
Right ventricle pressures
26/0
Left ventricle pressures
121/0
Left atrium pressures
7/3
What are the four valves
Tricuspid valve - located between RA and RV
pulmonary valve located between the RV and the PA
Mitral valve located between the LA and LV
aortic valve located between LV and aorta
What is a bicuspid aortic valve
Aortic valve with only two cups/flaps instead of 3 - aortic valve controls flow of blood from LV to the aorta , the main artery delivering blood to your body
What valve is normally the only bicuspid valve
Mitral valve between LA and LV
When does systole occur
Mitral valve and tricuspid closing to when aortic and pulmonary vlaves close
When does diastole occur
Aortic and pulmonary close to mitral and tricuspid close
What is isovolumetric contraction
Early systole where ventricles contract with no corresponding volume change (isovolumetrically ) - all heart valves are closed
What is isovolumetric relaxation
Interval in cardiac cycle closure of aortic valve to onset of filling by opening of mitral valve
Cardiac output
Volume of blood pumped out by heart by ventricles per minute
Stroke volume
Volume of blood ejected from each benticle due to each contraction
SV is the difference between end diastolic volume and end systolic volume
Heart rate
Number of beats per minute
Ejection fraction
How much blood the left ventricle pumps out with each contraction, 60% means 60perfent of total amount of blood in the left ventricle is pushed out with each heartbeat
At what pressure and volume does mitral valve open at
3mmHg
40ml
At what pressure and volume does mitral close
6mmHg
110ml
At what pressure and volume does the aortic open
75mmHg
110ml
What pressure and volume does aortic close
90mmHg
40ml
Coronary blood flow what is it
250mL/min - 5% of CO
Auto regulates MAP between 50-120mmHg
In coronary vasoconstriction Po2 increases and alkalosis occurs what happens in coronary vasodilation
Lowered PO2 and increased PCO2 causing acidosis and lactate and adenosine build up
What receptor needs to be stimulated for coronary vasoconstriction
Alpha 1
What receptor needs to be stimulated for coronary vasodilation
Beta 2
What hormone can cause coronary vasodilation
Prostacyclin
What hormones can cause coronary vasodilation
ADH
Angiotensin
Thromboxane
What is the first heart sound caused by
Closure of mitral and tricuspid vlaves
What is the second heart valine csused by
Closure of aortic and pulmonary vlaves
What sided valves normally close fractionally ahead
Left
How does turbulent flow produce sound
Vibrations in surrounding structures
What’s a stenotic valve
Shift or narrowed valve that doesn’t open correctly - ejection murmurs as blood forced through small gap
What is a regurgitant valve
Valve edges scarred - don’t close completely so badkflow of blood
How can murmurs be divided and subdivided
Into valvular and non-valvular
Valvular into stenotic and regurgitant
Non-valvular can be either normally pathway flow with pregnancy or abnormal pathway with ASD; VSD; PDA
In the timing of valvular murmurs the mitral and tricuspid in stenosis occurs in diastole and in incompetence is systole what are the aortic and pulmaory vlaves in both stenosis and incompetence
Systole and diastole