Cardiac Cycle

:BY
Makkawi .A.A. Osman
B.Sc, M.Sc
Department of physiology
Session No – (2)
Cardiac cycle
 Definition
 The cardiac events that occur
from the beginning of one
heartbeat to the beginning of the
next.
Duration:
The normal heart rate is about 75
beats/min
Each beat is regarded as one
cardiac cycle
Each cycle takes about 0.8 s ( 60/75)
Phases:
 Atrial systole (takes 0.1)
 Ventricular systole (takes 0.3 )
 Atrial diastole (takes 0.7)
 Ventricular diastole (takes 0.5)
Cardiac cycle (diastole)
Cardiac cycle (systole)
Pressure & volume change
LV Pressure volume curve
left:
Decreased stroke
volume due to
decreased force of
contraction.
Right:
Decreased stroke
volume due to
decreased end
diastolic volume
Length of systole & diastole
Contraction & repolarizing of cardiac
muscles faster when heart rate is high
Duration of systole ↓ from 0.27s at HR
65 beats to 0.16s at rate of 200
beats/min
When HR ↑, diastole is shortened, at
HR 65, duration is 0.62s whereas at HR
200 its 0.14s
Important of this timing
1.Rests the muscles
2.Coronary blood flow to the
subendocadial portions of the left
ventricle
3.Most of ventricular filling occurring
during this phase
At HR up to 180, filling adequate
At very high rate, filling may be
compromised
High rate at which the ventricles
can contract is about 400
beats/min
But AV node not conduct more
than 230 impulses/min
Rate more than 230 seen only in
paroxysmal ventricular tachycardia
Arterial pulse
Force of the blood from the aorta moves
blood vessels forwards & set up pressure
wave
The pressure expands the arteries
Expansion is palpable as the pulse
Rate of the travel is about 4m/s in aorta,
8m/s in large arteries & 16m/s at small
arteries
The pulse felt in the radial artery about 0.1s
after peak of systolic ejection
Strength of pulse determine by pulse
pressure
Is weak (thready) in shock, strong when
stroke volume is a large as in exercise .
Also strong when aortic valve is incompetent
(aortic insufficiency ), which is called a
collapsing
Atrial pressure changes & the
jugular pulse
 Atrial pressure rises during atrial systole &
isovolumetric ventricular contraction
 This pressure changes transmitted & producing
three types of waves in the record of jugular
pressure
1. The a wave due to atrial systole
2. The c wave is manifestation of the rise artrial
pressure produced by bulging of the A-V valves
backward toward the atria
3. The v wave show the rise in atrial pressure before
the tricuspid valve open
Cardiac cycle
Heart sounds
 Two sounds normally heard during each cardiac
cycle
 First sound is a low, slightly prolonged ‘’lub’’
caused by vibration due to sudden closure of the
AV valves.
 Second sound is shorter, high pitched ‘’dub’’
produced by vibration set up by closure of aortic &
pulmonary valves
 Third sound, a soft, low- pitched due to vibration
set up by inrush of blood
 Fourth sound heard sometimes when atrial
pressure is high or in ventricular hypertrophy
Coronary blood flow

no blood flow during systole in the

subendocardial portion of the left
ventricle, and is the most common site of
myocardial infarction
 Chemical Factors
 There is relationship between coronary
blood flow and myocardial O2 consumption
indicates that one or more of the products of
metabolism cause coronary vasodilation
 Include:
O2 lack , increased local concentrations of
CO2, H+, K+, lactate, prostaglandins,
adenine nucleotides, and adenosine
 Neural Factors
 The coronary arterioles contain
 β-adrenergic receptors >>>>>>> vasodilation
 α-adrenergic receptors
>>>>>>vasoconstriction
 vasodilation is due to production of
vasodilator metabolites
 Stimulation of vagal fibers to the heart dilates
the coronaries.
 Circumflex

Left anterior
descending
Right coronary
artery
Pathophysiology of AMI

Throm
bus

Coronary Artery
 Murmurs
 Murmurs are abnormal sounds
 Commonly used to denote noise heard over the
heart
 Laminar flow is silent, but turbulent flow creates
sound
 Blood flow speeds when artery or heart valves
narrowed
 The cause of cardiac murmurs is disease of the
heart valves
 When the orifice of the valve is narrowed (stenosis),
blood flow accelerate & turbulent
When a valve is incompetent, blood
flows backward via it (regurgitation)
Vascular sounds include:
Bruit heard over a large, high vascular
goiter
Over carotid artery when its lumen is
narrowed
Patent ductus arteriosus
Heart murmurs
Time of murmur abnormality valve

Systole Stenosis Aortic or pulmonary

diastole Insufficiency
Diastole Stenosis Mitral or tricuspid

Systole Insufficiency
‫‪ ‬لبست ثوب الرجاء والناس قد رقدو وقمت أشكوا إلي موالي ماأجد‬
‫‪ ‬وقلت يارب باعدني في كل نائبة ومن عليه لكشف الضر‪ H‬أعتمد‪.‬‬
‫‪ ‬أشكوا أليك أمورا أنت تعلمها ومالي علي حملها صبر وال جلد‪.‬‬
‫‪ ‬وقد مددت إليك يدي بالذل مبتهال ياخير من مدت إليه يد‪.‬‬
‫‪ ‬فال تردنها يارب خالية فبحر جودك ير‪H‬وي كل من يرد‬
‫‪ ‬لبست ثوب الرجاء والناس قد رقدو وقمت أشكوا إلي موالي ماأجد‬
‫‪‬وقلت يارب باعدني في كل نائبة ومن عليه لكشف الضر أعتمد‪.‬‬
‫‪‬أشكوا أليك أمورا أنت تعلمها ومالي علي حملها صبر‪ H‬وال جلد‪.‬‬
‫‪‬وقد مددت إليك يدي بالذل مبتهال ياخير من مدت إليه يد‪.‬‬
‫‪‬فال تردنها يارب خالية فبحر‪ H‬جودك يروي كل من يرد‬