Cardiac output

Cardiac output

The amount of blood pumped out by each ventricle per minute is called cardiac output(CO). It is a product of heart rate (HR) and stroke volume (SV). Heart rate or pulse is the number of beats per minute. Pulse pressure = systolic pressure– diastolic pressure. Stroke volume (SV) is the volume of blood pumped out by one ventricle with each beat. SV depends on ventricular contraction. CO = HR X SV. SV represents the difference between EDV (amount of blood that collects in a ventricle during diastole) and ESV (volume of blood remaining in the ventricle after contraction). SV = EDV - ESV. According to Frank – Starling law of the heart, the critical factor controlling SV is the degree to which the cardiac muscle cells are stretched just before they contract. The most important factor stretching cardiac muscle is the amount of blood returning to the heart and distending its ventricles, venous return. During vigorous exercise, SV may double as a result of venous return. Heart’s pumping action normally maintains a balance between cardiac output and venous return. Because the heart is a double pump, each side can fail independently of the other. If the left side of the heart fails, it results in pulmonary congestion and if the right side fails, it results in peripheral congestion. Frank – Starling effect protects the heart from abnormal increase in blood volume.

Blood Pressure

Blood pressure is the pressure exerted on the surface of blood vessels by the blood. This pressure circulates the blood through arteries, veins and capillaries. There are two types of pressure, the systolic pressure and the diastolic pressure. Systolic pressure is the pressure in the arteries as the chambers of the heart contracts. Diastolic pressure is the pressure in the arteries when the heart chambers relax. Blood pressure is measured using a sphygmomanometer (BP apparatus). It is expressed as systolic pressure / diastolic pressure. Normal blood pressure in man is about 120/80mm Hg. Mean arterial pressure is a function of cardiac output and resistance in the arterioles. The primary reflex pathway for homeostatic control of mean arterial pressure is the baroreceptor reflex. The baroreceptor reflex functions every morning when you get out of bed. When you are lying flat the gravitational force is evenly distributed. When you stand up, gravity causes blood to pool in the lower extremities. The decrease in blood pressure upon standing is known as orthostatic hypotension. Orthostatic reflex normally triggers baroreceptor reflex. This results in increased cardiac output and increased peripheral resistance which together increase the mean arterial pressure.