Heart rate is the number of times the heart beats in one minute.

The average adult resting heart

rate is 75 beats per minute (bpm). Stroke volume is the amount of blood pumped by each
ventricle with each heartbeat. The average adult resting stroke volume is 70 ml per beat. Cardiac
output is the amount of blood pumped out by each ventricle in one minute. It is directly related to
heart rate and stroke volume
Heart Rate x Stroke Volume = Cardiac Output
The SA node of the heart is enervated by both sympathetic and parasympathetic nerve fibers.
Under conditions of rest the parasympathetic fibers release acetylcholine, which acts to slow the
pacemaker potential of the SA node and thus reduce heart rate. Under conditions of physical or
emotional activity sympathetic nerve fibers release norepinephrine, which acts to speed up the
pacemaker potential of the SA node thus increasing heart rate. Sympathetic nervous system
activity also causes the release of epinephrine from the adrenal medulla. Epinephrine enters the
blood stream, and is delivered to the heart where it binds with SA node receptors. Binding of
epinephrine leads to further increase in heart rate.

End-diastolic Volume
An increase in venous return of blood to the heart will result in greater filling of the
ventricles during diastole. Consequently the volume of blood in the ventricles at the end of
diastole, called end-diastolic volume, will be increased. A larger end-diastolic volume will
stretch the heart. Stretching the muscles of the heart optimizes the length-strength
relationship of the cardiac muscle fibers, resulting in stronger contractility and greater
stroke volume.

2. Investigate the factors that contribute to cardiomegaly and

how they affect cardiac output.
Under conditions of rest, the heart does not fill to its maximum capacity. If the heart were
to fill more per beat then it could pump out more blood per beat, thus increasing stroke
volume. Also, the ventricles of the heart empty only about 50% of their volume during
systole. If the heart were to contract more strongly then the heart could pump out more
blood per beat. In other words, a stronger contraction would lead to a larger stroke
volume. During periods of exercise, the stroke volume increases because of both these
mechanisms; the heart fills up with more blood and the heart contracts more strongly.
Stroke volume is increased by 2 mechanisms:
1. increase in end-diastolic volume
2. increase in sympathetic system activity

Increased sympathetic stimulation due to fright or anger increases heart rate. The cardiac muscle
cells of the ventricular myocardium are richly enervated by sympathetic nerve fibers. Release of
norepinephrine by these fibers causes an increase in the strength of myocardiall contraction, thus
increasing stroke volume. Norepinephrine is thought to increase the intracellular concentration of
calcium in myocardial cells, thus facilitating faster actin/myosin cross bridging. Also, a general
sympathetic response by the body will induce the release of epinephrine from the adrenal
medulla. Epinephrine, like norepinephrine will stimulate an increase in the strength of
myocardial contraction and thus increase stroke volume.

Age

An infant has a higher heart rate than adults, usually at 115 beats per minute. This gradually
decreases and stabilizes to around 100 bpm as the person matures.

Gender
Females have a usually higher resting heart rate than male adults.

Physical fitness
A physically active person usually has a resting heart rate at around 50 bpm.

Body temperature
Increase in temperature will also increase your cardiac output.
It is therefore important that a person should be aware of these factors, to avoid applying undue
stress and pressure on the heart muscles.
Chronic high blood pressure, smoking, drug use, kidney disease, high cholesterol, lack of
exercise, poor diet and other genetic and lifestyle factors can affect the heart's ability to contract

and pump blood.