Cardiac Cycle
Cardiac Cycle Overview
The cardiac cycle consists of alternating contractions and relaxations of the atria and ventricles, causing blood to move from areas of higher pressure to areas of lower pressure.
Blood always flows from high pressure to low pressure.
Heart Chamber Contraction and Relaxation
Contraction of the heart chambers is called systole.
Relaxation of the heart chambers is called diastole.
When a chamber of the heart contracts, the pressure inside increases.
When a chamber of the heart relaxes, the pressure inside drops.
Duration of a Cardiac Cycle
In an average sized healthy adult at rest:
One cardiac cycle lasts approximately 0.8 seconds.
About half of this time is for systole (contraction) and the other half for diastole (relaxation).
Phases of the Cardiac Cycle
1. Ventricular Filling
Occurs after the ventricles have ejected blood.
The right ventricle pushes blood into the pulmonary trunk, and the left ventricle pushes blood into the aorta.
Ventricles relax, which causes pressure inside ventricles to drop quickly.
Atria have higher pressure than ventricles, leading to the opening of the atrioventricular (AV) valves (tricuspid and bicuspid valves).
Blood flows from atria to ventricles, during which:
The entire heart is relaxed.
This phase is called ventricular filling.
2. Atrial Systole
Occurs after ventricular filling.
Atrial walls contract, contributing an extra volume of blood into the ventricles.
This phase lasts about 0.1 seconds.
Approximately 25 milliliters of blood is added to the ventricles during this phase.
At the end of atrial systole, the ventricles are also done with relaxation, nearing the end of ventricular diastole.
3. Isovolumetric Contraction
Following atrial systole, the atrial walls relax and the ventricular walls begin to contract.
Lasts about 0.05 seconds.
All four valves are closed at this time, and the volume of blood in the ventricles does not change.
Isovolumetric contraction occurs as the ventricular walls contract, building pressure without volume change.
4. Ventricular Systole
Lasts approximately 0.3 seconds.
As pressure rises inside the ventricles, it forces the opening of the semilunar valves (pulmonary and aortic).
The pressure in the left ventricle must exceed 80 mmHg to open the aortic semilunar valve.
The pressure in the right ventricle must exceed 20 mmHg to open the pulmonary semilunar valve.
5. Ventricular Ejection
Occurs after the semilunar valves open and lasts about 0.25 seconds.
The right ventricle ejects about 70 milliliters of blood into the pulmonary trunk.
The left ventricle also ejects about 70 milliliters of blood into the aorta.
This volume ejected per heartbeat is called stroke volume.
At the end of ventricular ejection, 16 milliliters of blood remains in each ventricle, termed end-systolic volume.
6. Isovolumetric Relaxation
Following ventricular ejection, the ventricles relax, and pressure drops quickly.
Blood in the pulmonary trunk and aorta begins backflowing toward ventricles, causing the closure of the semilunar valves.
At this stage, all four heart valves are closed.
The ventricles are relaxed, but the volume of blood inside does not change during this phase.
Eventually, the pressure in the atria exceeds that in the ventricles, prompting the opening of the AV valves and initiating a new cycle with ventricular filling again.
Regulation of Blood Flow
The opening and closing of the AV valves and semilunar valves regulate blood flow into and out of the ventricles.
Ventricular filling occurs when AV valves are open.
Atrial systole also allows blood to flow into ventricles when AV valves are open.
Ventricular ejection occurs when semilunar valves are open.
During isovolumetric contractions and relaxations, all valves are closed, preventing flow and maintaining volume.
Atrial Blood Reception
The atria constantly receive blood through veins:
Right atrium receives blood via the superior vena cava, inferior vena cava, and coronary sinus.
Left atrium receives blood via the four pulmonary veins.
There are no valves at the openings of these veins into the atria, allowing for continuous blood flow into the atria during all phases of the cardiac cycle.