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NCLEX Cardiac Review

The heart is a highly specialized blood vessel which pumps 72 times per minute and propels about 4,000 gallons (about 15,000 liters) of blood daily to the tissues. It is composed of:

Endocardium (lining coat; epithelium)
Myocardium (middle coat; cardiac muscle)
Epicardium (external coat or visceral layer of pericardium; epithelium and mostly connective tissue)

Impulse conducting system

Cardiac Nerves: Modification of the intrinsic rhythmicity of the heart muscle is produced by cardiac nerves of the sympathetic and parasympathetic nervous system. Stimulation of the sympathetic system increases the rate and force of the heartbeat and dilates the coronary arteries. Stimulation of the parasympathetic (vagus nerve) reduces the rate and force of the heartbeat and constricts the coronary circulation. Visceral afferent (sensory) fibers from the heart end almost wholly in the first four segments of the thoracic spinal cord.

Cardiac Cycle: Alternating contraction and relaxation is repeated about 75 times per minute; the duration of one cycle is about 0.8 second. Three phases succeed one another during the cycle:

a) atrial systole: 0.1 second,

b) ventricular systole: 0.3 second,

c) diastole: 0.4 second

The actual period of rest for each chamber is 0.7 second for the atria and 0.5 second for the ventricles, so in spite of its activity, the heart is at rest longer than at work.