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Cardiology · Slide 14

What is the Frank-Starling mechanism and why does it matter clinically?

Stroke volume increases with greater end-diastolic volume - the heart pumps what it receives. Clinically relevant in heart failure, where this mechanism becomes impaired.

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Slide 14 - Cardiac Output

• Cardiac output (CO) = Heart rate × Stroke volume. Normal resting value is ~5 L/min.

• Frank-Starling law: increased venous return → greater EDV → stronger contraction → higher SV. The heart self-regulates to match preload.

• Clinical relevance: in systolic heart failure the Frank-Starling curve flattens - the ventricle cannot increase SV despite elevated filling pressures.

• Afterload, contractility, and heart rate are the other determinants of CO - covered on Slide 15.

Which statement best describes the Frank-Starling mechanism?

Heart rate increases proportionally with venous return

Stroke volume rises as end-diastolic volume increases

Afterload is reduced when preload is elevated

Contractility is independent of calcium influx

Correct! That's the Frank-Starling law.

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Slide 14 - Cardiac Output

Frank-Starling law: greater filling → greater contraction. CO = HR × SV (~5 L/min at rest).

Impaired in systolic heart failure - see Slide 15 for afterload & contractility.

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High PEEP increases alveolar pressure, which compresses pulmonary capillaries and raises pulmonary vascular resistance - increasing RV afterload. This is covered in slide 19 of your deck.

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