CARDIOPHYSIOLOGY CASE

A 28-year old male has these cardiovascular values and 12 Lead ECG strip

Parameter Value
Systolic pressure (Aorta) 120 mmHg
Diastolic pressure (Aorta) 80 mmHg
R-R interval 1 second
Left ventricular end-diastolic volume 140 mL
Left ventricular end-systolic volume 55 mL
Mean pulmonary artery pressure 16 mmHg
Right atrial pressure 2 mmHg
Left atrial pressure 5 mmHg
O2 consumption (whole body) 250 mL/min
O2 content of systemic arterial blood 0.2 mL O2/mL blood
O2 content of pulmonary arterial blood 0.151 mL O2/mL blood

Questions:
1. Define and calculate the following: (discuss how it was calculated)
a. Mean arterial pressure
b. Pulse pressure
c. Stroke volume of left ventricle
d. Cardiac Output of left ventricle
e. Ejection fraction of the left ventricle
2. Calculate cardiac output using the Fick principle.
3. Define total peripheral resistance (TPR). Which equation describes the relationship
between TPR, arterial pressure and cardiac output? What is the value of TPR in this
case?
4. How is pulmonary vascular resistance calculated? What is the value of pulmonary
vascular resistance in this case? Compare the calculated values for pulmonary vascular
resistance and TPR and explain any difference in the two values.
5. What is the total blood flow (in mL/min) through all of the pulmonary capillaries?
6. What is the total blood flow (in mL/min) through all of the systemic arteries?
7. If the diameter of the aorta is 20 mm, what is the velocity of aortic blood flow? Would
you expect the velocity of blood flow in systemic capillaries to be higher than, lower
than, or the same as the velocity of blood flow in the aorta?
8. Draw a left ventricular pressure-volume loop if the pressure in the left ventricle is 15
mmHg at the start of isovolumic contraction increasing to 80 mmHg at the end of
isovolumic contraction; and the pressure at the beginning of isovolumic relaxation is 110
mmHg and 10 mmHg at the end of isovolumic relaxation. Discuss the events occurring in
the loop.
a. Superimpose a new pressure–volume loop to illustrate the effect of an increase
in left ventricular end-diastolic volume (i.e., increased preload). What is the
effect on stroke volume?
b. Superimpose a new pressure–volume loop to illustrate the effect of an increase
in contractility. What is the effect on end-systolic volume? What is the effect on
ejection fraction?
c. Superimpose a new pressure–volume loop to illustrate the effect of an increase
in aortic pressure (i.e., increased afterload). What is the effect on end-systolic
volume? What is the effect on ejection fraction?