Cycle of the heart 1. Rapid ventricular filling Ventricular filling causes vibrations heard as S3 2.

Slow Ventricular filling Atria contract and eject blood into resistant ventricles, causing vibrations heard as S4 3. Isovolumetric contraction Ventricular pressure rises, closing the mitral and tricuspid valves and causing vibrations heard as S1. 4. Ventricular ejection The aortic and pulmonic valves open and the ventricles eject blood. 5. Isovolumetric relaxation Ventricular pressure falls, and the aortic and pulmonic valves close, causing vibrations heard as S2. Sinus Bradycardia It occurs when the sinus node creates an impulse at a slower-than-normal rate Sinus Tachycardia It occurs when the sinus node creates an impulse at a faster-than-normal rate. Sinus Arrhytthmia It occurs when the sinus node creates an impulse at irregular rhythm. Premature Atrial Complex It occurs when and electrical impulse starts in the atrium before the next normal impulse of the sinus node. Atrial Flutter It occurs in the atrium and creates impulse at a regular atrial rate between 250-400 times per minute Obesity As weight increases, so does the bodys total blood volume, forcing the heart to work harder to deliver oxygen and nutrients to the body. This increased workload causes the left ventricle t thicken, which affects the hearts ability to function effectively. Obesity can also affect the heart indirectly by increasing blood pressure and total cholesterol and triglyceride levels. It can also lead to obstructive sleep apnea, which can damage the heart. Coronary Atherosclerosis It is an abnormal accumulation of lipid or fatty substances and fibrous tissue in the lining of arterial blood vessel walls which creates blockage and narrow the coronary vessels in a way that reduces blood flow to the myocardium. Angina pectoris The cause is insufficient coronary blood flow, resulting in a decreased oxygen supply when there is increased myocardial demand for oxygen. Myocardial Infarction It is caused by reduced blood flow in a coronary artery due to rupture of an atherosclerotic plaque and subsequent occlusion of the artery by a thrombus.

Mitral Valve prolapse The cause is usually inherited connective tissue disorder resulting in enlargement of one or both of the mitral valve leaflets. Mitral Regurgitaion The leaflets cannot close because of the thickening and fibrosis of the leaflets and chordae tendinae, resulting in their contraction. Mitral Stenosis Often caused by rheumatic endocarditis which progressively thickens the mitral valve leaflets and chordae tendinae. The leaflets fuse together. Eventually, the mitral valve orifice narrows and progressively obstructs blood flow into the ventricle. Aortic Regurgitaion It maybe caused by inflammatory lesions that deform the leaflets of the aortic valve, preventing them from completely closing the aortic valve orifice Aortic Stenosis The aortic valve has calcified and restricts blood flow, causing a midsystolic, low-pitched, harsh murmur that radiates from the valve to the carotid artery Progressively narrowing of the valve orifice occurs. The left ventricle overcomes the obstruction to circulation by contracting more slowly but with greater energy than normal. The obstruction to left ventricular outflow increases pressure on the left ventricle. The ventricular wall thickens or hypertrophies Rheumatic Endocarditis Injury is caused by an inflammatory or sensitivity reaction to streptococci. Leukocytes accumulate in the affected tissues and form nodules, which eventually replaced by scar tissue. Infective Endocarditis A deformity or injury of the endocardium leads to accumulation on the endocardium of fibrin and platelets and clot formation. Heart Failure Inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients