{"id":3191,"date":"2026-06-16T07:21:22","date_gmt":"2026-06-16T15:21:22","guid":{"rendered":"https:\/\/www.nicolekupchikconsulting.com\/news\/?p=3191"},"modified":"2026-06-16T07:21:23","modified_gmt":"2026-06-16T15:21:23","slug":"understanding-cardiac-output","status":"publish","type":"post","link":"https:\/\/www.nicolekupchikconsulting.com\/news\/understanding-cardiac-output\/","title":{"rendered":"Understanding Cardiac Output"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">What determines cardiac output?\u00a0 It\u2019s an important concept to understand because there can be many different contributing factors that can impact your patient\u2019s cardiac output!\u00a0 The equation to calculate cardiac output is heart rate multiplied by stroke volume OR C.O. = HR x SV.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Did you know there are three components of stroke volume?\u00a0 I\u2019m sure you\u2019ve heard this before but let\u2019s refresh!\u00a0 Stroke volume is composed of preload, afterload and contractility.\u00a0 Let\u2019s do a deeper dive.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is stroke volume (SV)?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The amount of blood ejected out of the heart.<\/li>\n\n\n\n<li>Normal SV is 50 \u2013 100 mL\/beat.<\/li>\n\n\n\n<li>Normal SV index is 35 \u2013 60 mL\/beat\/m<sup>2<\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is preload?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It\u2019s the myocardial fiber length at the end of diastole prior to contraction.\u00a0 Think of it as the \u201cstretch\u201d of the heart.<\/li>\n\n\n\n<li>It can be equated to volume status <em>(with caution!)<\/em><\/li>\n\n\n\n<li>High preload = fluid overload <em>(But not always clinically true!)<\/em><\/li>\n\n\n\n<li>Low preload = fluid deficit<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><em>Estimated volume <\/em>on the right side of the heart &nbsp;<\/td><td><em>Estimated volume <\/em>on the left side of the heart: &nbsp;<\/td><\/tr><tr><td>Right Atrial Pressure (RAP)Central Venous<br> Pressure (CVP)Normal 2 \u2013 6 mm Hg<\/td><td>Pulmonary Artery Occlusive Pressure<br> (PAOP)Normal 8 \u2013 12 mm Hg<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is afterload?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>What your heart is pushing against.<\/li>\n\n\n\n<li>It\u2019s the resistance or pressure the ventricles must overcome to eject during systole.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td>Systemic Vascular resistance (SVR)<\/td><td>Pulmonary Vascular Resistance (PVR) &nbsp;<\/td><\/tr><tr><td>Defined as left ventricular afterload<br>Normal = 900 \u2013 1400 dynes\/sec\/cm<sup>-5<\/sup><\/td><td>Defined as right ventricular afterload<br>Normal = 90 \u2013 250 dynes\/sec\/cm<sup>-5<\/sup><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>\u2193<\/strong> afterload may be caused by: &nbsp;<\/td><td><strong>\u2191<\/strong> afterload may be caused by: &nbsp;<\/td><\/tr><tr><td>Vasodilation<strong>\u2193<\/strong> pressure needed to open the <br>aortic valve<strong>\u2191<\/strong> stroke volume \u00a0<\/td><td>Vasoconstriction Chamber size <br>Stenosis of an A-V valve (aortic stenosis)<br>Wall tension (hypertrophy)<br>More pressure needed to open the aortic valve<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What is contractility?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It is the FORCE of ventricular ejection.<\/li>\n\n\n\n<li>It is difficult to measure<\/li>\n\n\n\n<li>It is influenced by changes in preload &amp; afterload.<\/li>\n\n\n\n<li>\u201cInotrope\u201d\u00a0 +\/-<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Factors affecting contractility:<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Myocardial injury (MI, contusion)<\/li>\n\n\n\n<li>Sepsis<\/li>\n\n\n\n<li>Inadequate stretch<\/li>\n\n\n\n<li>\u2191 resistance<\/li>\n\n\n\n<li>Metabolic disturbances\/acidosis<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">If you found this interesting and want to learn more about the heart, check out Nicole\u2019s <a href=\"https:\/\/www.nicolekupchikconsulting.com\/booksAndCourses\/online-courses\/123\/cmc-review-course\">Cardiac Medicine Certification Course \u201cAce the CMC\u201d<\/a> which is currently on sale through June 18<sup>th<\/sup> at 30% off!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">References:<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www-uptodate-com.offcampus.lib.washington.edu\/contents\/pathophysiology-of-heart-failure-with-reduced-ejection-fraction-hemodynamic-alterations-and-remodeling?search=cardiac%20hemodynamics&amp;source=search_result&amp;selectedTitle=3~150&amp;usage_type=default&amp;display_rank=3&amp;searchCorrelationId=301e1787-8720-4aef-8069-a691b1d97a63&amp;searchCorrelationTerm=cardiac%20hemodynamics#H3854204765\">Pathophysiology of heart failure with reduced ejection fraction: Hemodynamic alterations and remodeling &#8211; UpToDate<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What determines cardiac output?\u00a0 It\u2019s an important concept to understand because there can be many different contributing factors that can impact your patient\u2019s cardiac output!\u00a0 The equation to calculate cardiac output is heart rate multiplied by stroke volume OR C.O. = HR x SV.\u00a0 Did you know there are three components of stroke volume?\u00a0 I\u2019m [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":2953,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[46],"tags":[],"ppma_author":[62],"class_list":["post-3191","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nurse-education"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>Understanding Cardiac Output - Nicole Kupchik Blog<\/title>\r\n<meta name=\"description\" content=\"Understand the factors affecting cardiac output. 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