Cardiac cycle

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The heart is a four-chambered pump which moves a 5 to 7.5 liter volume of blood throughout the circulatory system. The process can be broken down into five distinct phases: 1) Passive filling, 2) Atrial systole, 3) Isovolumetric ventricular contraction, 4) Rapid ventricular ejection, and 5) Isovolumetric ventricular relaxation.

The first phase, passive filling occurs in early diastole when blood enters the left ventricle through the mitral valve, causing expansion, while being replaced by pulmonary venous blood which continues to enter the left atrium. The pressure in the ventricle rises slowly as the ventricular volume increases. The volume of inflow diminishes until diastasis in mid and late diastole.

The second phase, atrial systole, begins as the active contraction of the atrium abruptly stops the pulmonary venous and systemic inflow. This rapidly pushes a small quantity of blood into the ventricles. This "atrial kick" pushes the final amount of blood into the already filled ventricles causing the pressure to rise in both ventricles initiating mitral and tricuspid valve closure.

Isovolumetric ventricular contraction occurs immediately following mitral and tricuspid valve closure. This isovolumetric contraction causes the pressure to rise in the left ventricle until aortic pressure is achieved. A similar process occurs in the right ventricle. However, the static pressure reached in the right ventricle is not as great because pulmonary resistance is lower than systemic resistance.

Once the pressure in the left ventricle exceeds the diastolic pressure in the aorta, the aortic valve opens and rapid ventricular ejection occurs. Once the aortic valve is open, the ventricle continues to contract rapidly until mid systole, after which the ejection of blood lessens. A similar process occurs on the right side of the heart.

The last phase, ventricular relaxation, causes the aortic valve to close as the ventricular pressure falls below the aortic diastolic level. The pressure in the ventricle continues to fall until it equals the pressure in the left atrium and falls slightly below it. This causes the mitral valve to open and allow passive filling to begin.


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