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Intended to be studies alongside companion notes of the same title. Prepared and presented by Marc Imhotep Cray, M.D.
Basic Medical Sciences and Clinical Knowledge (CK) Teacher
Topics Discussed
o o o o o o o Cardiac Function Curve (CO) Vascular Function Curve(VR) Right Atrial Pressure (RAP) Mean Systemic Pressure (MSP) Slope of the Vascular Function Curve Combining Cardiac and Vascular Function Curves Cardiovascular parameters that can alter CO, VR and RAP Inotropy Total Peripheral Resistance (TPR) Blood Volume (BV)
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Source: Tao Le T and Bhushan V, Cardiovascular, IN First Aid for the USMLE Step 1 2013; McGrawHill 2013:255
Cardiac cycle
The mechanical and electrical events that occur during one cycle are shown. Atrial systole (A); isovolumetric ventricular contraction (B); rapid ventricular ejection (C); reduced ventricular ejection (D);
SV/CO/VR
LVEDV / RAP/Preload
o Changes in either cardiac output curve and/or vascular function curve will cause a shift in the equilibrium point
Inotropic Agents
o Positive inotropic agent specific for the heart (e.g. digitalis) will shift cardiac output curve counterclockwise o Negative inotropic agent (e.g. metoprolol) specific for heart will shift cardiac output curve clockwise. similar shift for heart failure
o Effects of positive inotropic agents (A) o Effect of negative inotropic agents (B) The solid lines show the normal relationships, and the dashed lines show changes The circle intersecting the dashed line shows the new steady state operating point
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Effects of increased total peripheral resistance (TPR) on the cardiac and vascular function curves
o Effects of increased (TPR) (A) o Effects of decreased TPR (B) on the cardiac and vascular function curves The solid lines show the normal relationships, and the dashed lines show the changes The circle intersecting the dashed lines shows the new steady state operating point
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o Effects of increased blood volume (A) o Effects decreased blood volume (B) on the cardiac and vascular function curves The solid lines show the normal relationships, and the dashed lines show changes The circle intersecting the dashed line shows the new steady state operating point
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