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Dr Ebtehal El-Demerdash
Assist. Prof. of Pharmacology & Toxicology Faculty of Pharmacy, Ain Shms University
Overview
Introduction Drugs used for treatment of:
Hypertension Angina Arrhythmia Heart failure
CVS consists of: - HEART - BV - BLOOD It is a closed system inside which blood circulates CIRCULATORY SYSTEM
FORCE OF HEART
Homeostasis
Heart Anatomy
location Located within mediastinum, the medial cavity of the thorax
Heart Coverage
Enclosed by Pericardium 3 Layers
Outer-Epicardium
(thin cover)
Middle-Myocardium
(thick, ringlike, contractile)
Inner-Endocardium
(thin sheet between chambers)
Four Valves
The Right Atrioventricular Valve (right A-V valve); Tricuspide valve The Left Atrioventricular Valve (left A-V valve); Mitral valve The Pulmonic Valve The ortic Vlave
Circulation of Blood
We have two circulations Systemic & Pulmonary
Definitions
Systole: contraction of cardiac muscle Diastole: relaxation of cardiac muscle Heart rate (HR): number of heart beats/min (~ 75beats/min) Tachycardia: HR above 100beats/min Bradycardia: HR below 60beats/min Cardiac output (CO): total volume of blood pumped by each
ventricle/min
Ventricular Volumes
THE END-DIASTOLIC VOLUME(EDS): THE END-SYSTOLIC VOLUME (ESV): THE STROKE VOLUME (SV):
Volume of blood in the ventricle at the end of diastole
Volume of blood pumped by the ventricle per beat SV = EDV (135ml) ESV (65ml) = 70ml CO = SV x HR = 70 x 70 ~ 5L/min
Conductivity
Contractility
Autorhythmicity
independent of extrinsic stimuli regular cycle
Automaticity: ability of the heart to beat Rhythmicity: ability of the heart to beat in Autorhythmicity: ability of the heart to
beat regularly stimuli independent on extrinsic
rate
Pacemaker
SA-node Primary pacemaker 105 impulse/min Sinus rhythm AV-node Secondary pacemaker 45-60 impulse/min Nodal rhythm
Pacemaker Potential
Excitability
Excitability: ability of the heart to
respond to stimuli
Bathmotropism: an influence on
myocardial excitability
Phase
2:
The relative refractory period (RRP): The ventricles can respond Supernormal phase excitability (SNP): The Arrhythmia:
abnormal rhythm of heart beats heart
of
or
rate
Conductivity
between cardiac muscle fibers conductivity
Heart
block:
Contractility
muscle to change the potential energy of the food to mechanical energy contractility
Na+/Ca2+ exchanger:
This is an antiport carrier in the sarcolemma It exchanges Na+ at one side with Ca2+ on the other The direction depends on ion concentration on both sides
Mechanism of Contraction
Two types of proteins Relaxation Proteins:
Troponin Tropomyocin
Contraction proteins:
Actin Myosin
Role of Ca++ in Cardiac and Smooth Muscle In cardiac muscle, Ca++ binding to troponin C relieves troponin inhibition of actin-myosin interactions In smooth muscle, Ca++ binding to calmodulin activates myosin light chain kinase which in turn phosphorylates the Plight chain of myosin and triggers contraction (i.e. actin-myosin interactions)
Electrocardiogram (ECG)
P: atrial depolarization
(atrial systole)
PR interval: represents
QS interval: represents
Which are the principle effects of stimulation of sympathetic nerve to the heart?
a- Activation of 1adrenoceptors c- Increased contractile force d- Decreased automaticity e- Facilitation of AV conduction b- Increased heart rate