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Clinical pharmacy 2024/2025             Level 2 Pharm D                       Physiology and Pathophysiology (MD303)
 2) Relation between stroke & cardiac output & venous return

 Stroke volume   Definition  Volume of blood pumped by the ventricle / beat.
 (SV)   SV = End diastolic Volume (EDV) - End systolic volume (ESU) = 135ml - 65ml = 70ml
 Cardiac   Definition  The rate at which blood is pumped from ventricle. /Min [i.e. CO = the volume of blood pumped/min by each

 Output   ventricle.
 (CO)   C0 = SV X HR = 70 X 70 = [4900 ml] 5 liter/min
 In Steady State     COP of left Heart (The systemic blood flow) = Cardiac Output of the right heart (the Pulmonary blood
 flow)
  SV or  HR   CO        &        SV or  HR   C0

 Definition  The rate at which blood is returned to the atria/ min [The greater the VR  The greater the CO]
 Venous
   VR   EDV   Ventricular muscle length = stretch   Contractility   SV   CO
 Return
   An  of TPR cause  a  in both CO & VR
 (VR)
 In Steady State    VR to right atrium = VR to left atrium = COP from Left ventricle


                 .
 Factors affecting cardiac output مهم
 Factor   Definition & Relation
 1. Contractility (directly)   ↑contractility ➔ ↑ SV ➔  ↑ COP
  It is the load on heart before contraction & equals to EDV.
 2. Preload (EDV)
  SA is directly proportional to preload.  [↑ EDV ➔ ↑ COP]
 directly proportional
  EDV   Stretches ventricular muscle fibers  Strength of
   ضابقنلاا لبق دوهجملا
 ventricular contraction

   load on heart after contraction  ➔
 3. Afterload     Or pressure against which the ventricle pumps blood
  و نيطبلا لباقيب   يللا  طغضلا    After load = total Peripheral Resistance =(arterial pressure)

   ضبقني  وه    SV is inversely proportional to after load.
     An  after load [↑ arterial pressure or ↑ TPR] ➔  in SV  ➔ ↓
 CO
 4. Venous return    Venous return ➔  EDV  ➔  ventricular muscle length ➔  contractility➔ SV  ➔   CO


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