Syllabus · Historical · V4 (2023) · Cardiovascular System
G3 · Determinants and Control of Cardiac Output
G3.iii · Determinants and Control of Cardiac Output
Define the components and determinants of cardiac output including the effects of positive pressure ventilation.
Written examination
SAQ history
Cardiac Output — Afterload
4 exam appearances
Define afterload (10% marks) and describe the physiological factors that may affect afterload on the left ventricle (90% marks).
53%
Define afterload (10% of mark). Describe the factors that can affect left ventricular afterload (90% of mark).
20%
Cardiac Output — Afterload Increase
3 exam appearances
The systemic vascular resistance is suddenly increased, describe the consequences for the otherwise healthy left ventricle.
11%
Describe the consequences for the left ventricle of a sudden and sustained increase in afterload.
7%
Cardiac Output — Contractility
1 exam appearance
Define myocardial contractility and briefly describe dP/dT, the end systolic pressure volume (ESPV) relationship and the ejection fraction (EF).
13.6%
Cardiac Output — Determinants
2 exam appearances
Discuss the regulation of cardiac output. Illustrate your answer by using a graph to describe the important physiological relationships.
44%
Cardiac Output — LV Function
1 exam appearance
Cardiac Output — Preload
2 exam appearances
Cardiac Output — RV Output
1 exam appearance
Cardiac Output — Venous Return
3 exam appearances
Oral examination
VIVA history
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2025A · Day 2 · VIVA 5
This VIVA will examine cardiovascular physiology and pharmacology. Using this cardiac function curve (VR and CO); explain the physiological principles demonstrated by these curves and identify ‘A’& ‘B’ (image removed from report)
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2023A · Day 1 · VIVA 6
This VIVA will examine cardiovascular physiology. Please identify and describe the key features of this graph. What are the main factors that affect venous return to the heart? (Image removed from report.)
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2023A · Day 2 · VIVA 6
This VIVA will examine cardiovascular physiology. Please identify and describe the key features of this graph. What are the main factors that affect venous return to the heart? (Image removed from report.)
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2021A · Day 1 · VIVA 8
This viva will explore your knowledge of measurement of cardiac output and the determinants of systemic vascular resistance (SVR). How can the cardiac output be measured?
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2019B · Day 3 · VIVA 5
This viva will test your knowledge on contractility. Define contractility as it relates to cardiac function.
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2017B · Day 2 · VIVA 4
This viva is about cardiovascular physiology and calcium. Define afterload and list the components.
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2016B · Day 1 · VIVA 3
This viva discussed cardiovascular physiology including measurement of cardiac output, the Valsalva manoeuvre and alterations with acute blood loss.
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2016A · Day 1 · VIVA 1
This viva tested knowledge of cardiovascular physiology. It discussed cardiac output, stroke volume, sarcomere length myocardial contractility, the role of calcium and then related pharmacology of drugs that increase cardiac contractility including catecholamines and digoxin.
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2016A · Day 2 · VIVA 1
This viva tested knowledge of cardiovascular physiology and pharmacology, the Frank Starling mechanism, venous return and stroke volume. It went on to discuss cardiac output measurement and the pharmacology of milrinone, West’s zones of the lung and pulmonary vascular resistance.
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2010B · VIVA 2
This viva will test your knowledge of cardiac physiology and blood pressure measurement. Outline the factors that affect cardiac output. This viva tested the candidates’ knowledge of cardiovascular physiology, specifically determinants of cardiac output, ventricular stroke work, volume loops, etc. It also tested knowledge of invasive arterial pressure measurement, including that relating to ideal design features of measuring systems and sources and types of errors of measurement. Candidates seemed to only have a superficial understanding of cardiac output and it’s determinants, they lacked depth in their explanations and were less familiar with right sided heart pressures and function. Measurement principles were much better covered.
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2007B · VIVA 6
Cardiogenic shock (BP 90/60, CI 1.8, SVR 1500). What drugs would you use to increase the blood pressure?
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.