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LA BOMBA CARDIACA
IGNACIO GUTIERREZMAURICIO MEZAMARIO MONTIELLEONARDO PEREZ
FACULTAD DE MEDICINAI SEMESTRE
¿QUÉ ES LA BOMBA CARDIACA?
• Fisiología del musculo cardiaco.
• Anatomía fisiológica del musculo cardiaco.
• El musculo cardiaco como sincitio.
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.
POTENCIALES DE ACCION EN EL MUSCULO CARDIACO
potencial de acción 105mV potencial intracelular -85mV entre los latidos hasta un valor ligeramente positivo +20mV
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
ACOPLAMIENTO EXCITACIÓN-CONTRACCION
• Mecanismo mediante el cual el potencial de acción hace que las miofibrillas del musculo se contraigan.
DÚRACION DE LA CONTRACCIÓN
CICLO 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:
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
Primer ruido cardiaco (S1) : Segundo sonido cardiaco (S2) :Tercer sonido cardiaco (S3) :Cuarto sonido cardiaco (S4) :
RUIDOS CARDIACOS
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:
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:
DETERMINANTES DEL GASTO 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:
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:
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 igualesEl volumen sistólico aumenta en tanto se Incrementa el llenado cardiaco
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 :
EFECTOS DE LOS CAMBIOS EN LA CONTRACTILIDAD DEL MÚSCULO
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:
RESUMEN DE LOS DETERMINANTES DEL GASTO 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:
CURVAS DE FUNCIÓN CARDIACA
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:
RESUMEN DE LAS INFLUENCIAS NEURALES SIMPATICAS SOBRE LA
FUNCIÓN CARDIACA
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:
ENERGÍA CARDIACA
Fuentes de energíaPara 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:
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:
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:
GRACIAS
