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RA: 2-8 mmHg
RV: 15-25 mmHg systolic; 2-8
mmHg diastolic PA: 15-25 mmHg
Intra-chamber pressures
systolic; 8-14 mmHg diastolic LA: 6-
12 mmHg
LV: 110-130 mmHg systolic; 6-12
mmHg systolic Aorta: 110-130 mmHg
systolic; 70-80 mmHg diastolic
CO= HR x SV
CO= 4-8
L/min
Cardiac Output (CO) HR=60-
100 SV=
60-100 mL
Cardiac output is the amount of blood ejected in L/min;
measures tissue perfusion/assessment of blood flow. Affected
by body size, O2 demand, metabolic rate.
Right: CVP: 0-8 mmHg
Left: PAD: 8-14 mmHg; PAWP 6-12 mmHg
Preload is the amount of end diastolic stretch on the
myocardial muscle fibers. The relationship of volume in the
Preload (filling/volume) chambers and the compliance of the chambers; think of a
balloon!
Starling's Law: The greater the stretch during diastole, the
greater the force of contraction in systole and the greater the
cardiac output (CO)
Low preload: fluids
High preload: Diuretics, nitrates, morphine
, Right: PVR (pulm vasc resistance) 150-250
Left: SVR (systemic vasc resistance) 800-1200; MAP: 60-90
Afterload is the resistance the ventricles must overcome in
order to eject blood forward. BP, SVR (left), PVR (right).
Afterload (resistance)
Low afterload: Vasopressors; levo, dopamine, neo, epi,
vasopressin [+alpha for vasoconstriction]
High afterload: Venodilators; nipride,
captopril, flolan [-alpha for
vasodilation]
SV: 60-100 ml/min
EF: >40%
Contractility is the inotropic state of the myocardium; depends
on healthy muscle, intact cardiac cell membrane and normal
Contractility (squeeze)
electrolyte balance (Mg, K, Ca) Increased: sympathetic
stimulation (fight vs flight), vasoactive meds.
Decreased: myocardial hypoxia/ischemia, negative intropic
medications. Low contractility: Inotropes; dobutamine,
milrinone
High contractility: antidysrhthmics; BB, Ca+ blockers.
CI= 2.0-4.0
To calculate CI; CI=CO (4-8)/BSA
Cardiac Index (CI)
Cardiac index is the cardiac output in relation to the body size;
assessment of blood flow.
SV= 60-100 mL/beat
To calculate SV; SV=CO (4-8)/HR
Stroke volume (SV)
Stroke volume is the amount of blood ejected per beat;
assessment of pump function.
Normal EF: >40%
To calculate EF; EF= amount of blood ejected (SV)/amount of
Ejection fraction (EF)
blood available (EDV) Ejection fraction is the % of available
preload that is ejected as stroke volume with each beat;
efficiency of LV as a pump.
Normal MAP: 70-110 mmHg
To calculate MAP; SBP+2(DBP)/3
MAP is the average BP throughout the cardiac cycle; used to
Mean arterial pressure (MAP)
titrate gtts; consistent throughout arterial circulation
regardless of location.