Introduction:

The Cardiac Cycle

This diagram shows
pressure and volume
changes during one heart
beat for the left side of
the heart.
Pressures are much less
on the right side.
Introduction:
ECG
The Cardiac Cycle
Aortic
Pressure

Left Ventricular
Pressure Heart
Sounds
Left Atrial
Pressure
Left
ventricular
Volume
Latter stages of
Introduction:
ventricular diastole:

The Cardiac Cycle

Heart is at rest

LA pressure > LV pressure

Therefore AV valve is open
Blood going into ventricle

Aortic pressure > LV pressure

Therefore semilunar valve is shut
Atrial systole:
Introduction:
The Cardiac Cycle
ECG – P wave

Atrial depolarisation leads to atrial

contraction

Rise in atrial pressure, followed by

a drop

Increase in ventricular filling

Atrial systole:
Introduction:
The Cardiac Cycle
ECG – baseline

Time for excitation to conduct

through the AV node
Latter stages of
Introduction:
Atrial diastole/beginning of
ventricular systole:
The Cardiac Cycle
ECG – QRS complex

Q-R rapid depolarisation through

the bundle of His – bundle
branches toward the apex

R-S depolarisation spreads up the

wall of the heart

Ventricular depolarisation (leads to

ventricular contraction)

Ventricular pressure becomes

greater than atrial pressure

Mitral valve closes

First heart sound “lub”

(tricuspid valve also closes)
Earlierstages of
Introduction:
ventricular systole:

The Cardiac Cycle

Aortic valve – Shut

Mitral Valve – Shut

Ventricles contract – left

ventricular pressure goes up

Ventricle is sealed so the volume

does not change ‘isovolumic’
Ventricular systole:
Introduction:
The Cardiac Cycle
Ventricular contraction continues

Therefore, ventricular pressure

continues to rise.

When it exceeds the aortic pressure

the aortic (semilunar) valve opens
(i.e. pressure exceeds the
‘afterload’)

Blood can be ejected from the

ventricles into the aorta
Ventricular systole:
Introduction:
The Cardiac Cycle

End diastolic volume

End systolic volume

Latter stages of
Introduction:
ventricular dsystole:

The Cardiac Cycle

ECG – T wave

Ventricles repolarising

Therefore ventricles relax

Blood ‘attempts’ to flow back from

aorta into the ventricle

Ventricular pressure < aortic

pressure

Aortic valve closes

End of
Introduction:
ventricular systole:

The Cardiac Cycle

Dichrotic notch

Second heart sound ‘dub’

(aortic and pulmonary valves close)
Early stages of
Introduction:
ventricular diastole:

The Cardiac Cycle

Aortic valve – Shut

Mitral Valve – Shut

Ventricles relax– left ventricular

pressure goes down

Ventricle is sealed so the volume

does not change ‘isovolumic’
Ventricular systole/diastole:
Introduction:
The Cardiac Cycle
Note that:

During ventricular systole blood

has been returning to the atria

Therefore atrial pressure has been

rising

When atrial pressure exceeds

ventricular pressure, mitral valve
opens
Ventricular diastole:
Introduction:
The Cardiac Cycle
The valve opening allows blood
that has accumulated in the atria to
enter the ventricle

Both the atria and ventricle are

relaxed but...

Atrial pressure > ventricular

pressure

This begins a passive filling of the

ventricle during ventricular
diastole
Latter stages of
Introduction:
ventricular diastole:

The Cardiac Cycle

ECG – P wave

And so on ...