DR JYOTHI VYBHAVI

Heart Rate
&
it’s Regulation
DR JYOTHI VYBHAVI
ASSISTANT PROFESSOR
BLCMCRI
 DR JYOTHI VYBHAVI

Normal Heart Rate

Normal Heart
rate in adults is
70-80 beats per
minute
 DR JYOTHI VYBHAVI

Physiological Factors
Affecting
Heart Rate
 DR JYOTHI VYBHAVI

AGE
As age increases vagal tone increases and HR decreases but in old
age HR is slightly higher due to fall in vagal tone

Fetal 12 yrs, 18 yrs, 60 yrs,

HR= 140-150bpm 70-80bpm Up to 100 bpm
Up to 100bpm
At Birth
HR = 130-140bpm
 DR JYOTHI VYBHAVI

Sex

Higher HR in females due to Increased resting

Sympathetic tone & lower Systemic BP
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Body Temperature

For each 1℃ rise in body

temperature HR increases
by 10bpm due to effect on
SA node. It produces
Cutaneous Vasodilation
causing fall in systemic BP.
 DR JYOTHI VYBHAVI

Marey’s Law

Marey’s law states that Heart Rate is inversely

related to Blood Pressure

Exception during Exercise both Heart

Rate and Blood pressure both increase
 DR JYOTHI VYBHAVI

Working of Baroreflex

Stimulus Effector Organ Physiological Effect

• Increased Arterial • Heart • Decreased HR
Pressure • Blood Vessels • Decreased Contractity
• Vasodilation, Decreased
CO

Receptor Efferent N
• Baroreceptors • Increased BP :Vagus
• Decreased BP:
Sympathetic

Afferent Nerve Integrating Centre

• Glossopharangeal N • Nucleus Tractus
• Vagus N Solitarius
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Diseases

Increased Intracranial Hypoxia

Thyrotoxicosis
Pressure
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Emotions

Excitement Fear Anger

Increase in Heart rate and Hypertension

 DR JYOTHI VYBHAVI

Exercise

HR increases linearly with

severity of exercise
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Respiration- Sinus Arrythmia

HR increases during
INSPIRATION and
decreases during
EXPIRATION. This
Phenomenon is called
Sinus Arrythmia
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Regulation
Of
Heart Rate
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Regulation

Regulation of HR

Autonomic
Reflexes Reflexes Other
Nervous
outside Heart within Heart Reflexes
System
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Autonomic Nervous System

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Autonomic Nervous System

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Reflexes from outside the Heart

Baroreceptor
Mechanism

Vasomotor Chemoreceptor
Centre Mechanism
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Reflexes arising within

the Heart
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Reflexes arising within the Heart

Right Atrial Atrial Natriuretic

Bain Bridge Reflex
Stimulation Peptide

Left Ventricular Bezold Jarisch

Stimulation Reflex
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Bain Bridge Reflex

Rapid Infusion of Saline or blood

Activation of Tachycardia -producing

Atrial Receptors

This increases the Heart Rate

This Reflex Response is Bain Bridge

Reflex

This Reflex competes with Baroreceptor Reflex & the Reflex is diminished or absent
when heart rate is low
 DR JYOTHI VYBHAVI

Right Atrial Stimulation

Stretch of Right Atrium

Stimulates A & B receptors

Through Vagus Efferent Nerves

Sympathetic Parasympathetic

Increase Heart Rate

Reduces load on Right Side Heart

 DR JYOTHI VYBHAVI

Role of Atrial Natriuretic Peptide

It increases
Atrium
Release of ANP Sodium and
Distension
water Excretion

Reduces
Produces
Cardiac
Vasodilation
Congestion
 DR JYOTHI VYBHAVI

Left ventricular Stimulation

Stretch of Left Atrium

Stimulates receptors

Decrease Heart Rate & Vasodilation

 DR JYOTHI VYBHAVI

Bezold –Jarisch Reflex

( Coronary Chemoreflex)

Chemicals like Veratridine, seretonin into coronary arteries

/ Substances released by damaged Myocardium

Activate the ventricular receptors which discharge

irregularly

Rapid Breathing, Apnoea ,Bradycardia, Hypotension

 DR JYOTHI VYBHAVI

Other Reflexes regulating

the Heart
 DR JYOTHI VYBHAVI

List of all Other reflexes

influencing HR
Sinus Arrythmia
Bain Bridge Reflex
Temperature
Exercise
Advanced stages of Pregnancy
Hormones like Epinephrine & Thyroxine
Shock , Heart Failure Increases HR
Sleep decreases HR
Athletes have slow heart rate
Pain increases HR
 DR JYOTHI VYBHAVI

Applied Aspects
 DR JYOTHI VYBHAVI

Applied Aspects

Tachycardia Bradycardia
Increase in HR Decrease in HR
> 90beats/min < 60beats/min
Physiological causes: Physiological causes:
Exercise, Anxiety, Sleep & Athletes
Emotions Pathological causes:
Pathological causes: Myxoedema & Heart
Fever & Thyrotoxicosis Blocks
 DR JYOTHI VYBHAVI

ARTERIAL PULSE
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Arterial Pulse Tracing

Percussion wave occurs due

to ejection of blood during
ventricular systole.

Dicrotic notch represents

closure of aortic valve.

Dicrotic wave occurs due to

rebound of blood against the
closed aortic valve during
diastole.
 DR JYOTHI VYBHAVI

Heart Sounds
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Heart Sounds
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Heart Sounds

Normal
S1, S2, S3, S4
Sounds

Functional SYSTOLIC
Sounds of CVS
Murmurs MURMURS
Cardiac
Sounds Abnormal Flow

Murmurs DIASTOLIC
MURMURS

Abnormal SYSTOLIC
Systole( Clicks)
Sounds +
Abnormal Valves DIASTOLIC
Arterial System
(BRUITS) Diastole(Snaps)
Extra cardiac
Pericardial Rub
Sounds
Venous system
(VENOUS HUM)
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First Heart Sounds

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Second Heart Sounds

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Third Heart Sounds

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Fourth Heart Sounds

DR JYOTHI VYBHAVI
DR JYOTHI VYBHAVI