Postgraduate Education BS Physical Therapy, Silliman University, 1996 BS Zoology, MSU-Iligan Institute of Technology 1999 Doctor of Medicine, Mindanao State University-College of Medicine Post-graduate Internship University of the Philippines, Philippine General Hospital 2003-2004 Internal Medicine Residency University of the Philippines, Philippine General Hospital 2004-2007 Fellowship in Cardiology University of the Philippines, Philippine General Hospital 2008-2011 Affiliations Fellow, Philippine College of Physcians Fellow, Philippine Heart Association Fellow, Philippine College of Cardiology

JILL IRENE Z. CAPISTRANO MD, FPCP, FPCC

The ECG complex

ECG Phonogram

Pre

ssu

re (

mm

Hg

)

RA

LA

LV

RV

Ventricular filling

Atrial Contraction

Ventricular filling (mid to late diastole)

120

80

40

0

Atrial pressure > Ventricular pressure AV valves open Atrium contract Blood flow from atrium to ventricle Atrial pressure < Ventricle pressure

AV valves close

ECG Phonogram

Pre

ssu

re (

mm

Hg

)

Isovolumic contraction

phase Ventricular ejection

phase

Ventricular systole (atria in diastole)

120

80

40

0

AV valves closed

Ventricles contract

Ventricular Pressure >

Ao/Pa Pressure

Ao/Pa valves open

LV/RV eject blood into Ao/Pa

ECG Phonogram

Pre

ssu

re (

mm

Hg

)

Isovolumic relaxation

phase Ventricular

filling

Early Diastole

120

80

40

0

Ao/Pa pressure > ventricular pressure

Ao/Pa valves close

Ventricles relax

Ventricular P <Atrial P

AV valves open

Atrium empty blood

into ventricle

Ven

tric

ula

r V

olu

me

(ml)

130

100

70

Atrioventricular valve

Aortic & Pulmonary

valve

1

2a 2b 3 1

CLINICAL CORRELATES