The document discusses the cardiac cycle and physiology of the heart muscle. It defines the cardiac cycle phases and changes in pressure and volume that occur in the atria, ventricles, and aorta during each phase. It also discusses cardiac output and index, the action potential in heart muscle, the refractory period of heart muscle, excitation-contraction coupling, the duration of contraction, heart sounds, the left and right pumps, factors influencing systolic volume, and the effects of changes in preload and afterload on the ventricles.

1. IGNACIO GUTIERREZ
MAURICIO MEZA
MARIO MONTIEL
LEONARDO PEREZ
FACULTAD DE MEDICINA
I SEMESTRE

2. ¿QUÉ ES LA BOMBA CARDIACA?
• Fisiología del musculo cardiaco.
• Anatomía fisiológica del musculo cardiaco.
• El musculo cardiaco como sincitio.

3. OBJETIVOS
• Enumerar las principales fases distintas del ciclo
cardiaco
• Describir los cambios de presión y volumen en las
aurículas, los ventrículos y la aorta durante cada
fase del ciclo cardiaco.
• Definir el gasto e índice cardiacos.

6. POTENCIALES DE ACCION EN EL
MUSCULO CARDIACO
potencial de acción 105mV
potencial intracelular -85mV
entre los latidos hasta un valor
ligeramente positivo +20mV

8. PERIODO REFRACTARIO DEL
MÚSCULO CARDIACO
• Intervalo de tiempo durante el cual un
Impulso cardiaco normal no puede re excitar
una zona ya excitada del musculo cardiaco.
Periodo de tiempo refractario relativo adicional

10. ACOPLAMIENTO EXCITACIÓN-
CONTRACCION
• Mecanismo mediante el cual el potencial de
acción hace que las miofibrillas del musculo
se contraigan.

11. DÚRACION DE LA CONTRACCIÓN

12. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch
WJ, Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion
models and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

13. BOMBA IZQUIERDA:
- diástole ventricular
- sístole ventricular
BOMBA DERECHA:
Las presiones que desarrolla el
corazón derecho, se
consideran más bajas que
aquellas del corazón izquierdo.
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the descending
limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left ventricle in a single beat
and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ, Lefkowitz RJ, Rockman HA.
Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models and cardiac output computing
methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles

16. Primer ruido cardiaco (S1) :
Segundo sonido cardiaco (S2) :
Tercer sonido cardiaco (S3) :
Cuarto sonido cardiaco (S4) :
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left ventricle
in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ, Lefkowitz RJ,
Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models and cardiac
output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

17. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the descending
limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left ventricle in a single
beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ, Lefkowitz RJ, Rockman
HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models and cardiac output
computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

19. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left ventricle
in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ, Lefkowitz RJ,
Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models and cardiac
output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

20. INFLUENCIA SOBRE EL VOLUMEN
SISTÓLICO:
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

21. EFECTO DE LOS CAMBIOS EN LA
PRECARGA VENTRICULAR:
LEY DE FRANK-STARLING DEL
CORAZON
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:
Ley de starling del corazón:
Establece que con otros factores iguales
El volumen sistólico aumenta en tanto se
Incrementa el llenado cardiaco

23. EFECTO DE LOS CAMBIOS EN LA
POSCARGA VENTRICULAR
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

25. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

27. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

30. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

31. Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the descending limb.
News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left ventricle in a single beat and the
influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ, Lefkowitz RJ, Rockman HA. Functional
consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models and cardiac output computing methods. Am J
Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

32. Fuentes de energía
Para que el corazón funcione de manera
adecuada, debe tener una provisión suficiente de
energía química en la forma de (ATP)
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

33. MEDICIÓN DE LA FUNCIÓN CARDIACA
Gasto cardiaco
Índice cardiaco
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

34. ESTIMADOS DE LA
CONTRACTILIDAD CARDIACA
• TÉCNICAS DE IMAGENOLOGÍA
• FRACCIÓN EXPULSADA
• RELACIÓN PRESIÓN SISTÓLICA FINAL-VOLUMEN
Chemla D, Coirault C, Hebert JL, Lecarpentier Y. Mechanics of relaxation of the human heart. News Physiol Sci. 2000;15:78–89. Elzinga G. Starling’s “law of the heart”: Rise and fall of the
descending limb. News Physiol Sci. 1992;7:134–137. Howell WH, Donaldson F. Experiments upon the heart of the dog with reference to the maximum volume of blood sent out by the left
ventricle in a single beat and the influence of variations in venous pressure, arterial pressure, and pulse rate upon the work done by the heart. Philos Trans R Soc. 1884;175:139–160. Koch WJ,
Lefkowitz RJ, Rockman HA. Functional consequences of altering myocardial adrenergic receptor signaling. Annu Rev Physiol. 2000;62:237–260. Millard RK. Indicator-dilution dispersion models
and cardiac output computing methods. Am J Physiol. 1997;272: H2004–2012. Sagawa K. The end-systolic pressure-volume relationship of the ventricles:

36. GRACIAS