Saturday, April 5, 2025

Cardiac Physiology Made Simple

 

I sketched out a  very simple and brief outline on the Living Body and how it  works here:

 

https://c.blogspot.com/2025/04/the-living-body-how-it-works.html


I thought I should write just a little bit more using just two examples - the heart and the lungs among other organs and body systems so that readers can have a glimpse how beautifully the body is designed  

 

The Physiology of the Heart

The heart is a remarkable organ responsible for pumping oxygenated and deoxygenated blood throughout the body. It works as the central component of the cardiovascular system, which also includes arteries, veins, and capillaries. The heart's function is regulated by various factors, including blood volume, hormones, electrolytes, the autonomic nervous system (sympathetic and parasympathetic), and organs such as the kidneys and adrenal glands.

Structure and Function of the Heart

The heart is a muscular organ divided into four chambers: the right atrium, right ventricle, left atrium, and left ventricle. Blood follows a dual circulatory pathway:

1. Pulmonary circulation: Deoxygenated blood is pumped from the right ventricle to the lungs for oxygenation and returns to the left atrium.

2. Systemic circulation: Oxygenated blood is pumped from the left ventricle to the rest of the body.

The heart’s pumping function is driven by cardiac muscle contractions, regulated by electrical impulses originating from specialized cells.

Electrical Conduction System of the Heart

The rhythmic contraction of the heart is controlled by its electrical conduction system, ensuring coordinated pumping of blood. The key components include:

1. Sinoatrial (SA) Node: The heart’s natural pacemaker, located in the right atrium. It generates electrical impulses that spread through the atria, causing them to contract.

2. Atrioventricular (AV) Node: Located between the atria and ventricles, it receives impulses from the SA node and delays them slightly to allow complete atrial contraction before ventricular contraction.

3. Bundle of His: A collection of fibers that transmit electrical signals from the AV node to the ventricles.

4. Purkinje Fibers: These fibers distribute impulses throughout the ventricles, ensuring coordinated contraction for efficient blood ejection.

Cardiac Output and Hemodynamics

Cardiac function is assessed by several key parameters:

1. Cardiac Output (CO): The volume of blood ejected per minute, calculated as:

2. Stroke Volume (SV): The volume of blood pumped out with each contraction, determined by:

3. Preload: The degree of ventricular stretch before contraction, dependent on venous return.

4. Afterload: The resistance the left ventricle must overcome to eject blood, closely related to blood pressure.

5.Ejection Fraction (EF): The percentage of blood ejected from the left ventricle per beat. Normal EF is >55%; a low EF suggests heart failure.

Heart Blocks and Their ECG Characteristics

Heart blocks occur when there is a delay or interruption in electrical conduction. There are three types:

1. First-Degree Heart Block:

Prolonged PR interval (>0.20 seconds) on ECG.

Electrical impulses are delayed but still reach the ventricles.
Usually asymptomatic and may not require treatment.

2. Type I (Wenckebach/Mobitz I): PR interval gradually lengthens until a beat is dropped (missed QRS complex).2. Second-Degree Heart Block:
Type II (Mobitz II): Sudden loss of QRS complexes without PR interval prolongation.
Type II is more severe and may require a pacemaker.

3. Third-Degree (Complete) Heart Block:

No communication between atria and ventricles.

Atrial and ventricular rhythms are independent.
Requires immediate medical attention and pacemaker implantation.

Conclusion

The heart’s physiology is a finely tuned system regulated by mechanical and electrical components. Understanding its function, conduction system, and potential abnormalities helps in diagnosing and treating cardiovascular diseases. Advances in medical science, including pacemakers and medications, have significantly improved the management of heart disorders, ensuring better patient outcomes.

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