CARDIAC CYCLE

ATRIAL SYSTOLE
The end of diastole

Heart: Prior to atrial systole, blood has been flowing passively from the atrium into the ventricle through the open AV valve. During atrial systole the atrium contracts and tops off the volume in the ventricle with only a small amount of blood. Atrial contraction is complete before the ventricle begins to contract.

Atrial pressure: The "a" wave occurs when the atrium contracts, increasing atrial pressure (yellow). Blood arriving at the heart cannot enter the atrium so it flows back up the jugular vein, causing the first discernible wave in the jugular venous pulse. Atrial pressure drops when the atria stop contracting.

ECG: An impulse arising from the SA node results in depolarization and contraction of the atria (the right atrium contracts slightly before the left atrium). The P wave is due to this atrial depolarization. The PR segment is electrically quiet as the depolarization proceeds to the AV node. This brief pause before contraction allows the ventricles to fill completely with blood.

the isovolumic phase of ventricular systole is defined as the interval between the closing of the AV valves and the opening of the semilunar valves (aortic and pulmonary valves). approaching the pressure in the aorta and pulmonary arteries (green). As the ventricles contract isovolumetrically . ventricular systole is defined as the interval between the QRS complex and the end of the T wave (the Q-T interval). tricuspid incompetence. . Next phase ISOVOLUMETRIC CONTRACTION The beginning of systole Heart: The atrioventricular (AV) valves close at the beginning of this phase. Electrically. It occurs with hypertrophic congestive heart failure.their volume does not change (white) -.the pressure inside increases.Heart sounds: A fourth heart sound (S4) is abnormal and is associated with the end of atrial emptying after atrial contraction. or cor pulmonale. Mechanically. Pressures & Volume: The AV valves close when the pressure in the ventricles (red) exceeds the pressure in the atria (yellow). massive pulmonary embolism.

. Heart sounds: The first heart sound (S1. It is so large that it masks the underlying atrial repolarization signal. "lub") is due to the closing AV valves and associated blood turbulence. Previous phase Next phase RAPID EJECTION Heart: The semilunar (aortic and pulmonary) valves open at the beginning of this phase of ventricular systole.ECG: The electrical impulse propagates from the AV node through the His bundle and Purkinje system to allow the ventricles to contract from the apex of the heart towards the base. The QRS complex is due to ventricular depolarization. and it marks the beginning of ventricular systole.

creating a small wave into the jugular vein. the semilunar valves open.Pressures & Volume: While the ventricles continue contracting. It is normally simultaneous with the carotid pulse. The "c" wave of atrial pressure is not normally discernible in the jugular venous pulse. As more blood enters the arteries. the pressure in the ventricles (red) exceeds the pressure in the aorta and pulmonary arteries (green). blood exits the ventricles. and the volume in the ventricles decreases rapidly (white). ECG: Heart sounds: Previous phase Next phase REDUCED EJECTION The end of systole . pressure there builds until the flow of blood reaches a peak. Right ventricular contraction pushes the tricuspid valve into the atrium and increases atrial pressure.

This marks the end of ventricular systole mechanically. When the pressure in the ventricles falls below the pressure in the arteries. Heart sounds: Previous phase Next phase ISOVOLUMETRIC RELAXATION .Heart: At the end of this phase the semilunar (aortic and pulmonary) valves close. blood in the arteries begins to flow back toward the ventricles and causes the semilunar valves to close. The end of the T wave marks the end of ventricular systole electrically. ECG: The T wave is due to ventricular repolarization. blood flow out of the ventricles decreases and ventricular volume decreases more slowly (white). Pressures & Volume: After the peak in ventricular and arterial pressures (red and green).

S2 is normally split because the aortic valve closes slightly earlier than the pulmonary valve. The pressure in the ventricles (red) continues to drop.The beginning of diastole Heart: At the beginning of this phase the AV valves are closed. It is the second discernible wave of the jugular venous pulse. causing atrial pressure to rise gradually (yellow). "dup") occurs when the semilunar (aortic and pulmonary) valves close. ECG: Heart sounds: The second heart sound (S2. Ventricular volume (white) is at a minimum and is ready to be filled again with blood. Pressures & Volume: Throughout this and the previous two phases. Previous phase Next phase . The "v" wave is due to the back flow of blood after it hits the closed AV valve. the atrium in diastole has been filling with blood on top of the closed AV valve.

blood that has accumulated in the atria flows rapidly into the ventricles. ECG: Heart sounds: A third heart sound (S3) is usually abnormal and is due to rapid passive ventricular filling. or mitral incompetence. myocardial infarction. Previous phase . Pressures & Volume: Ventricular volume (white) increases rapidly as blood flows from the atria into the ventricles. severe hypertension.RAPID VENTRICULAR FILLING Heart: Once the AV valves open. It occurs in dilated congestive heart failure.

Next phase REDUCED VENTRICULAR FILLING (DIASTASIS) Heart: Pressures & Volume: Ventricular volume (white) increases more slowly now. The ventricles continue to fill with blood until they are nearly full. ECG: Heart sounds: .

Previous phase .

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