FUNDAMENTALS OF
CARDIOVASCULAR SYSTEM
Tarek Salem, MD, FEBC, FEBIC.
Consultant of Intervention cardiology
Team Leader of STEMI Pathway for Hail Region 1
Hail Cardiac Center
Learning objectives
Define the function of the heart
Discuss the heart anatomy
Understand the conduction system of the heart
Describe pulmonary circulation & systemic
circulation
Understand cardiac cycle and cardiac output
introduction
Cardiovascular system means the system of heart ,blood
vessels & blood of human body. The term “cardiovascular” is a
combination of two word; “Cardio” and “vascular”. The term
“cardio” is derived from “cardiac” meaning Heart and the term
“vascular” means blood vessels. So the name itself indicates
that cardiovascular systems is the system of heart and blood
vessels. Cardiovascular system is also known as “Circulatory
System”. A functional cardiovascular system is vital for
supplying oxygen and nutrients to tissues and removing wastes
from them.
introduction
Perfectly functioning cardiovascular
system is so important for human body.
The flow of blood is necessary for
existence of life. If the flow of blood is
stopped, life will stop.
Heart is the main organ of
cardiovascular system and it is
responsible for distributing blood all
over human body.
heart
The heart is a hollow, cone-shaped, muscular organ within
the thoracic cavity made of strong cardiac muscles.
Is roughly the size of a fist.
Weight 300 grams.
Beats 60-100 times/minute.
Pumps 5-7 L/min throughout the body.
Newborns' hearts beat faster than adult
hearts, about 70 to 190 beats per minute.
The heart is located in the center of the
chest,(mediastinum of the thorax)usually pointing
slightly left.
Apex —blunt, rounded point; most inferior part of
heart
Base —larger, flat portion; directed superiorly and
slightly posteriorly
function
Pumping of blood
• Heart separates pulmonary and systemic
circulations
Transport nutrients and oxygen
Transport waste to kidneys
Distribute hormones and antibodies
Help control body temperature and maintain
homeostasis
Generating blood pressure
Ensuring one-way blood flow
• Heart valves ensure one-way flow
LaYers of the heart WaLL
The heart wall consists of three layers enclosed in the
pericardium
1.EPICARDIUM/PERICARDIUM - which performs
several functions. Fluids within the sac lubricate the
outer wall of the heart so it can beat without causing
friction. It also holds the heart in place, forms a barrier
against infections, and helps keeps the heart from
overexpanding.
2. MYOCARDIUM - the muscular middle layer of the
wall of the heart and has excitable tissue and the
conducting system.
3. ENDOCARDIUM - the innermost layer of the heart is
formed of the endothelium and subendothelial
connective tissue.
four chambers
Right and left side act as separate pumps
Four chambers. A septum divides the
atrium and ventricle on each side.
2 Atria - Receiving chambers
• Right atrium
• Left atrium
2 Ventricles - Discharging chambers
•Right ventricle
•Left ventricle
major arteries
Giving AWAY blood
Aorta-
• Oxygenated blood
Pulmonary trunk
• Deoxygenated Blood
major veins
Giving IN blood/filling
Superior and inferior vena
cava
•Deoxygenated blood
Pulmonary veins
• Oxygenated blood
the vaLves
As the heart muscle contracts and relaxes,
the valves open and shut, letting blood
flow.
Valve helps in controlling blood flow
Plays an important role in preventing the
backflow of blood
• Tricuspid valve - 3leaflet/Cusps
• Bicuspid valve- 2 leaflet/cusps
• Semilunar valve
the coronarY arteries
The coronary arteries are the arterial
blood vessels of coronary circulation,
which transport oxygenated blood to the
heart muscle.
The coronary arteries are mainly
composed of the left and right coronary
arteries, both of which give off several
branches.
coronarY arteries
The left main coronary artery
branches into:
• Circum lex artery
• Left Anterior Descending artery (LAD)
The left coronary arteries supply:
• Circumflex artery - supplies blood to the
left atrium, side and back of the left
ventricle
• Left Anterior Descending artery (LAD) -
supplies the front and bottom of the left
ventricle and the front of the septum.
coronarY arteries
The right coronary artery
branches into:
•Right marginal artery
•Posterior descending artery
The right coronary artery supplies:
•Right Atrium
•Right Ventricle
•Bottom Portion of Both Ventricles
And Back of The Septum
conduction sYstem of heart
The pumping action of the heart
(heartbeat) is controlled by the
heart’s electrical system or
the cardiac conduction system.
Cardiac Conduction System
Electrical Impulses produce a
wave that can be recorded on the
ECG.
conduction sYstem of heart
Consists of…
1.Sinoatrial(SA) node
2. Atrioventriclular (AV) node
3. Bundle of His (AV Bundle)
4. Bundle Branches
5. Purkinje Fibers (network)
conduction sYstem of heart
SA NODE : Located in the upper right part of the atrium.
Is a natural pacemaker Fires at a rate of 60 to 100 times
per minute The heartbeat starts in the SA node.
AV NODE : Located in the floor of the right atrium Delays
or slows the electrical impulse Fires at a rate of 40 to 60
time per minute Can take over if the SA node is not
working
Bundle of His & Bundle branches: Located next to the
AV node Transfers the electrical impulse from the atria to
the ventricles
Purkinje Network :Provide an electrical pathway for
each of the cardiac cells Activate the left and right
ventricles simultaneously causing the ventricles to
contract
PULMONARY &
SYSTEMIC CIRCULATION
PuLmonarY & sYstemic circuLation
The purpose of the cardiovascular
system is to provide adequate
circulation of blood through the body.
The cardiovascular system consists of
two main loops.
The systemic circulation
The pulmonary circulation.
PuLmonarY & sYstemic circuLation
Pulmonary Circuit
The blood pathway between the
right side of the heart, to the lungs,
and back to the left side of the heart.
(Path of blood from right ventricle
through the lungs and back to the
heart)
Systemic Circuit
Oxygen-rich blood pumped to all
organ systems to supply nutrients.
cardiac cYcLe
It is the cardiac events that occur from
the beginning of one heart beat to the
beginning of the next beat.
These events consists of periods of
contraction called "systole" and a
period of relaxation called "diastole".
The cardiac cycle involves a complete
contraction and relaxation of both the
atria and ventricles and the cycle last
approximately 0.8 seconds
heart sounds
Produced from blood turbulence
caused by closing of heart valves
There are four heart sounds produced
during each cardiac cycle.
First & second heart sounds are more
prominent, appear as “LUB & DUB”
these sounds are heard by stethoscope.
heart sounds
S1 (“lub’’ Sound)
• First heart sound
• It is produced due to the simultaneous
closure of both the atrioventricular (mitral
& tricuspid) valves.
• This is long, soft & low pitched sound
S2 (“dub’’ Sound)
• Second Heart Sound
• Shorter and higher pitched.
• Closing of the aortic and pulmonary valves
(semilunar valves) as blood is pumped out
of the heart .
heart sounds
S3 (Third heart sound)
• It is produced during rapid filling period
of the cardiac cycle.
• It is also called ventricular gallop
produced during earlier part of diastole.
• Short & low pitched
S4 (Fourth heart sound)
• It is abnormal and is associated with the
end of atrial emptying after atrial
contraction.
• Short & low pitched sound
cardiac outPut
Cardiac output : It is the amount of
blood pumped by each ventricle per
minute. It varies physiologically with
age, body mass index, physical activity,
sleep, meals, pregnancy, etc. It is
number of beats per minutes
Stroke volume (SV) : Volume of blood
ejected by each ventricle/beat.
cardiac outPut
Stroke volume is expressed in
ml/beat and heart rate in
beats/minute. Therefore, cardiac
output is in ml/minute. Cardiac
output may also be expressed in
litres/minute.
CO = SV (Stroke volume) x HR
(Heart Rate)
cardiac outPut
End Diastolic Volume: Volume of blood in each
ventricle at the end of diastole. It is about 120 –
130 ml.
End Systolic Volume: Volume of blood in each
ventricle at the end of Systole. It is about 50 to 60
ml
Stroke volume (SV) = EDV – ESV
ejection fraction
Ejection fraction (EF) is the percentage of ventricular
end diastolic volume (EDV) which is ejected with each
stroke.
EF = SV (EDV – ESV) X 100
EDV
70 (120-50) X 100 = 58%
120
Ejection fraction in a healthy heart is 50% to 70%.
Ejection fraction is good index of ventricular function.
voLumes & fraction
references
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https://www.slideshare.net/webservtech1/power-point-the-
cardiovascular-system-anatomy-and-physiology
https://www.slideshare.net/webservtech1/power-point-the-
cardiovascular-system-anatomy-and-physiology
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