Chapter

Pushmi-Pullyu and the Right Atrium

James R. Munis

in Just Enough Physiology

Published on behalf of © Mayo Foundation for Medical Education and Research

Published in print December 2011 | ISBN: 9780199797790
Published online June 2012 | e-ISBN: 9780199929665 | DOI: http://dx.doi.org/10.1093/med/9780199797790.003.0007

Series: Mayo Clinic Scientific Press

Pushmi-Pullyu and the Right Atrium

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What does right atrial pressure (PRA) do to cardiac output (CO)? On the one hand, we've been taught that PRA represents preload for the right ventricle. That is, the higher the PRA, the greater the right ventricular output (and, therefore, CO). This is simply an application of Starling's law to the right side of the heart. On the other hand, we've been taught that PRA represents the downstream impedance to venous return (VR) from the periphery. That is, the higher the PRA, the lower the VR, and therefore, the lower the CO. The point of intersection between the 2 curves defines a unique blood flow rate, which is both CO and VR at the same time.

Chapter.  1339 words.  Illustrated.

Subjects: Professional Development in Medicine

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