Cardiac Cycle

Cardiac Cycle
• Cardiac cycle refers to the alternating

contraction and relaxation of the
myocardium in the walls of the heart
chambers coordinated by the conducting
system during one heart beat.
Phases of Cardiac Cycle
• There are basically six phases of cycle.
1. Atrial contraction
2. Isovolumetric contraction
3. Rapid ejection
4. Reduced ejection
5. Isovolumetric relaxation
6. Rapid filling
1. Atrial contraction
• It is the first phase of cardiac cycle. It is
initiated by the P wave of the
electrocardiogram which represents electrical
depolarization of the atria. Atrial
depolarization initiates contraction of the
atrial musculature. In this phase A-V valves
open and semilunar valves are closed. As the
atria contract, the pressure within the atrial
chamber increases which forces more blood
Atrial contraction
flow across the opened A-V valve, leading to a
rapid flow of blood into the ventricles. This phase
accounts for 10 to 40 % of the filling of the
ventricles. After atrial contraction is complete,
the atrial pressure begins to fall causing a
pressure gradient reversal across the AV valves.
This causes the valves to float upward before
closure. At this time ventricular volume is
maximum which is referred to as end-diastolic
volume (EDV). During the atrial contraction, the
heart sound is noted as S4, which is due to
vibration of the ventricular valves.
2. Isovolumetric contracton
This phase of the cardiac cycle begins with the appearance of
QRS complex of the ECG, which represents ventricular
depolarization. This triggers excitation-contraction
coupling, monocyte contraction and a rapid increase in
intraventricular pressure. The AV valve are closed when
intraventricular pressure increases the atrial pressure.
Closure of the AV valve results in the first heart sound (S1).
During the time period between the closure of the AV
valves and openning of the aortic and pulmonic valves,
ventricular pressure rises rapidly without a change in
ventricular volume (i.e. no ejection occurs). Ventricular
volume does not change because all valves are closed
during this phase. Contraction therefore is said to be
isovolumetric contraction.
3. Rapid ejection
This phase represents initial, rapid ejection of blood
into the aorta and pulmonary arteries from the
left and right ventricles, respectively. Ejection
begins when the intraventricular pressure exceed
the pressures within the aorta and pulmonary
artery, which causes the aortic and pulmonary
valve to open. AV valve remain closed during this
phase. No heart sound is usually noted during
this phase because openning of the healthy
valves is silent. The presence of sound during the
ejection i.e. systolic murmurs indicate valve
disease or intracardiac shunts.
4. Reduced Ejection
• In this phase ventricular repolarization occurs
as shown by the T-wave of the
electrocardiogram. Repolarization leads to a
decline in ventricular active tension and
pressure generation, therfore the rate of
ejection (ventricular emptying) falls.
5. Isovolumetric relaxation
when the intraventricular pressure falls sufficiently
at the end of phase 4, the aortic and pulmonary
valve abruptly close causing the second heart
sound (S2) and the beginning of isovolumetric
relaxation. Although ventricular pressure
decrease during this phase volumes do not
change because all valves are are closed. The
volume of blood that remains in a ventricle is
called the end-systolic volume. The difference
between the end-diatolic volume and the end-
systolic volume is -70 ml and represents the
stroke volume.
6. Rapid filling
• As the ventricles continue to relax at the end of
phase 5, the intraventricular pressures will fall
below their respective atrial pressures. When this
occurs, the AV valves rapidly open and passive
ventricular filling begins. Despite the inflow of
the blood from the atria, intraventricular
pressure continues to fall because ventricles are
still undergoing relaxation. Ventricular filling.
Third heart sound (S3) is audible during rapid
ventricular filling.
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Cardiac Cycle

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Cardiac Cycle

• Cardiac cycle refers to the alternating

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