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Pressur
e
change
s
Volume
changes
• Arterial START Cardiac Cycle
pulse and Events
pressure 1. Electrical events
• Venous – ECG
pulse and 2. Mechanical
pressure events – Systole
•(usually
Valve very
closure and diastole
low) 3. Hemodynamic
Turbulence
Heart sound events
• Pressure
• Valve changes
opening Flow changes:
usually silent
Diastole SA Systole
node
fires
1 2 3 4 1 2
Atrial Isovol. Ventr.
Isovol. Ventr. Relax. Rapid Filling Slow Filling Ventr. Ejection
Diastasis Systole Contr.
Atrial Systole
1. Rise in atrial pressure
2. “a” wave of venous pulse (due to atrial contraction,
backpressure go back to jugular vein)
3. Incr. blood flow to ventricle
4. Rise in intraventricular volume (30% of ventricular
filling)
Isovolumetric Ventricular Contraction
1. Rapid increase in intraventricular pressure
(without a change in ventricular volume because
all valves are closed)
2. Intraventricular pressure exceeds atrial pressure
Closure of the A-V Valve First heart sound
(S1) Ventricular Ejection
1. Ejection begins when the intraventricular
pressures exceed the pressures within the aorta
and pulmonary artery, which causes the aortic
and pulmonic valves to open
2. Blood continues to flow into the atria from their
respective venous inflow tracts and the atrial
Isovolumetric Ventricular Relax
1. Intraventricular pressures fall sufficiently, the aortic and
pulmonic valves abruptly close causing the second
heart sound (S2)
2. Ventricular volumes remain constant because all valves
are closed
3. Atrial pressures continue to rise because of venous
return Rapid Filling
1. Ventricular pressures fall below their respective atrial
pressures the AV valves open and ventricular filling
begins
2. This causes a rapid fall in Atrial Pressure
3. Ventricular filling is normally silent (When a third heart
sound (S3) is audible, it may represent tensing of
chordae tendineae and AV ring during ventricular
relaxation and filling) Slow Filling
1. Ventricles continue to fill with blood and expand, the
intraventricular pressures rise. This reduces the
pressure gradient across the AV valves so that the rate of
filling falls
2. In normal, resting hearts, the ventricle is about 70-90%
Pressure Changes
in left side of the
heart
Pressure Changes
in right side of the
heart
S1 : heart at beginning of
In Summary… atrial systole
S2: aortic & pulmonary valve
close (beginning of diastole)
Between s2 & s1: diastole
* Check carotid pulse
Arterial pulse
Pressure
wave changes in
Aorta are
transmitted
down the
arteries
100 100
Pressure
Pressure
(mmHg)
(mmHg)
50 50
0 0
0 50 100 150 0 50 100 150