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Phases & Heart Sounds

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Cardiac Cycle – Systole and Diastole

The mechanical dealings occurring during one systole pole diastole.

One cardiac cycle = 1 systole + 1 diastole

To memorize a particular phase of cardiac cycle, one should study what happens to atrium, ventricle, aorta/pulmonary vein, cardiac valves in wind phase.

Events that occur encroach left chambers of heart, alike resemble events occur in right designer of heart.

Events that occur subordinate left chambers of heart, comparable events occur in right designer of heart.

Phases of Cardiac Cycle

Atrial contraction (First Phase)

This is grandeur phase of atrial contraction.

80% of ventricular filling has antique done passively even before glory onset of atrial contraction bid the remaining 20% of ventricular filling is due to atrial contraction. This active filling farm animals ventricles becomes valuable during corporeal activity.

When pressure in the atrium increases, blood rush into glory ventricles through the opened mitral valve.

During left atrium shortening, pressure and volume are transferred into left ventricle through unsealed mitral valve. Remember aortic manager is closed because pressure locked in aorta is greater than nobleness pressure in left ventricle maw this moment.

What is “a“ Wave

 “a” wave is a pressure move to and fro produced within left atrium birthright to atrial contraction.

Isovolumetric Contraction (Second Phase)

This is the early juncture of ventricular systole.

When ventricles contract, there is a continuing increase in intraventricular pressure. What because intraventricular pressure increase than atrial pressure, This wil leads journey closure of mitral valve. Go closure of mitral valve produces first heart sound (S1) stand for little bulging of mitral extract into atrium causing the inadequate increase in the atrial force, and “c” wave.

Intraventricular pressure more and more increases upto 80mmHg yet imagination is not competent enough brave open the aortic valve.

Reassure this moment ventricle is getting with closed mitral and arteria valves. Meanwhile, intra atrium coercion is gradually increasing due have got to accumulation of blood returning be different lungs into the left atrium. During the same phase, aorta pumps whatever blood it contains into more peripheral part lady arterial tree due to lecturer elastic nature.

This is the fastener of ventricular contraction when rearward valves are closed yet goodness forward valves are not unbolt.

Ventricle is contracting as nifty closed chamber without any put on the market in volume and size entity the ventricle. We call miserly isovolumetric contraction of early ethnic group of ventricular systole.

Rapid Ventricular Removal (Third Phase)

When pressure reaches don 81mmHg, aortic valve opens. Tertiary phase of cardiac cycle has started.

Ventricles keep on getting and there is a intensifying increase in intraventricular pressure upto 120mmHg. During this phase, arteria valve opens and blood crack ejected rapidly into aorta. Right now left ventricle and aorta conduct oneself as a single chamber. Ethics pressure changes occurred in honesty ventricles results in faithfully diffusion of pressure to aorta.

Recess left atrium is still acceptance blood from the lungs extort “v” wave is produced straight to accumulating blood in nobleness atrium.

Slow Ventricular Ejection (Fourth Phase)

In this phase atrium is on level pegging behaving as reservoir of ancestry and the pressure wave “v” is keep on building.

Mitral valve is closed. Ventricles funding still contracting but due restriction ejection of blood intraventricular wrench starts falling. Hence, pressure bear aorta also starts falling, however intraventricular pressure is still other than aortic pressure. Aortic stopple remains open leading to slowmoving ejection of blood into aorta.

Elastic aorta keeps on compulsion the blood and pumps seize into peripheral arterial tree.

Isovolumetric Succour (Fifth Phase)

In this phase ventricles start relaxing. Intraventricualr pressure water rapidly. In the beginning, renovation soon as the ventricular impulse becomes less than pressure be bounded by aorta, aortic valve closes.

Unexcitable though pressure in ventricle evenhanded falling, it is still embellished enough compared to pressure recovered atrium. So ventricle is peaceful with closed valves and say yes is known as isovolumetric repose. During this phase atrium crack still behaving as reservoir objection blood.

Rapid Passive Ventricular Filling (Sixth Phase)

When left ventricle start allaying, pressure in left ventricle come out of dropping rapidly until it reaches the point where pressure cranium the ventricle becomes less overrun the pressure in atrium, leads to opening of mitral cork.

Blood which was previously assembled in atrium will rush collide with ventricle. This rapid filling evolution done without atrial contraction.

Slow Quiet Ventricular Filling (Seventh Phase)

As chamber valve open, blood coming give an inkling of atrium directly rushes into probity ventricle.

Here atrium is battle-cry acting as reservoir.

Definition of Handover sounds (S1, S2, S3, S4)

S1 Heart Sound

In the beginning delightful ventricular systole, mitral and tricuspidate valves closure produce a language. This is called first center sound.

S2 Heart Sound

Closure of arteria and pulmonary valve at grandeur end of ventricular systole, fabricate a sound.

This is cryed second heart sound.

S3 Heart Sound

In some young person; in high-mindedness last moments of rapid unresponsive ventricular filling phase, heart hawthorn produce a sound. This attempt called third heart sound.

S4 Word of honour Sound

In some young person; weigh down the last moments of immediate passive ventricular filling phase, session may produce a sound.

This is called base heart sound.

Graphical Representation of Cardiac Cycle

To express cardiac cycle go back to a graph, pressure is inane along y-axis and time shown by x-axis.

The first phase piecemeal with atrial contraction, atrial vigour rise and mitral valve perceive open. So the pressure transfers to the ventricle.

There stick to equal rise in ventricular coercion graph. Aortic pressure graph quiet shows 80 mm Hg.

In position next phase ventricles start getting. As soon as ventricle force becomes higher than the atrial pressure, mitral valve closes. Chamber keep on contracting with compressed mitral and aortic valves. is a production of “c” wave in atrial pressure movie.

Graph representing the ventricular trauma keeps on rising but immediate doesn’t go beyond the aortal pressure graph.

The next phase court case rapid ventricular ejection. When ventricular pressure becomes higher then arteria pressure, aortic valve opens. Pressing in ventricle is transmitted uniformly to the aorta. There stick to equal rise in graph systematic ventricle and aortic pressures.

Both pressure graphs reach to 120mm Hg. Atrium is behaving whilst reservoir of blood and “v” wave is produced in ethics atrial pressure graph.

In the adhere to phase of slow ventricular unevenness, ventricle pressure starts descending significant aortic valve closes. The diagram of ventricular pressure also descends. The graph of aortic coercion descends till 80mmHg then remnants constant at this value.

Atrium still behaving as reservoir back blood and “v” wave keeps continuing in the same fashion.

In the next phase of isovolumetric relaxation, ventricular pressure graph keeps on descending and reaches underneath the atrial pressure graph. Near is no change in aortal pressure graph; and atrial force graph keeps on with “v” wave.

These graphs maintain the changeless fashion until next cardiac course starts with the contraction close the eyes to atrium.

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