Explore
Change the physiology yourself. Pick a topic for a workspace set up for it, or open the full laboratory with everything.
Explore a topic
27 topics and conditions in 8 groups. Opening one never replaces an experiment in progress without asking.
Heart mechanicsLoading, contractility and relaxation on the pressure–volume loop.6
- Pressure–volume loopsRead stroke volume, filling and loading from one loop.Opens with Normal adult at rest
- PreloadFluid, end-diastolic volume and the cost in filling pressure.Opens with Normal adult at rest
- AfterloadResistance, arterial pressure and what the ventricle ejects against.Opens with Normal adult at rest
- ContractilityEnd-systolic elastance, ejection fraction and what each can and cannot tell you.Opens with Normal adult at rest
- Diastolic propertiesStiffness and relaxation: why the same volume can mean very different pressures.Opens with HFpEF, stiff LV (passive stiffness)
- The cardiac cycle (Wiggers)Valve timing, pressures, volume and flow through one beat.Opens with Normal adult at rest
Circulation and volumeVenous return, fluid response and normal pressures.3
- Starling and venous returnWhere the cardiac function curve meets the venous return line.Opens with Normal adult at rest
- Fluid response versus fluid toleranceA passive leg raise, the change in output and the change in filling pressures.Opens with HFrEF, dilated, chronically adapted
- Normal pressures and flowsWhere each pressure sits in a healthy circulation.Opens with Normal adult at rest
Waveforms and timingRecognising catheter waveforms, the cardiac cycle and rhythm.2
Valves and diseaseValve lesions and cardiomyopathies as reproducible parameter sets.10
- Aortic stenosisValve area, flow, simultaneous LV and aortic pressure, and the gradient.Opens with Aortic stenosis, severe (compensated)
- Aortic stenosisA fixed obstruction to LV ejection.Condition explorer · Moderate (1.2 cm²), Severe (0.7 cm²)
- Aortic regurgitationDiastolic leak from the aorta into the LV.Condition explorer · Acute (non-adapted LV), Chronic (dilated LV)
- Mitral stenosisObstruction to LV filling.Condition explorer · Severe (1.0 cm²)
- Mitral regurgitationSystolic leak into the LA.Condition explorer · Acute (normal LA), Chronic (compliant LA, dilated LV)
- Tricuspid regurgitation and stenosisRight-sided valve lesions change the RA waveform: regurgitation ventricularises it (large v wave) and reduces forward pulmonary delivery; stenosis produces a diastolic RA–RV gradient with a large a wave..Condition explorer · Severe TR (dilated RV), Tricuspid stenosis
- Obstructive hypertrophic cardiomyopathyA hypercontractile, small LV whose outflow tract narrows as the cavity empties (systolic anterior motion).Condition explorer · HOCM at rest
- Tamponade, constriction and restrictionThree ways to raise and equalise filling pressures with different respiratory behaviour: tamponade (fluid compresses all chambers, pulsus paradoxus), constriction (a rigid shell shields the heart from pleural pressure), restriction (stiff myocardium, normal pericardium)..Condition explorer · Tamponade, Constriction, Restriction
- Pulmonary hypertension and the right heartRaised PA pressure can arise from pulmonary vascular disease (pre-capillary), from left heart disease (post-capillary) or both.Condition explorer · Chronic pre-capillary (adapted RV), Post-capillary (left heart), Acute PE (unadapted RV)
- Dilated and hypertrophic failure phenotypesPressure overload remodels concentrically (thick, stiff, small cavity); volume overload remodels eccentrically (large, compliant cavity).Condition explorer · Dilated low output, Non-dilated low output, Concentric (stiff), Impaired relaxation
Shock and drugsShock phenotypes and multi-target drug effects.1
Heart–lung and provocationBreathing, ventilation, exercise and other physiological challenges.2
Support and interventionsMechanical circulatory support, shunts and structural interventions.2
- Mechanical support and shuntsIABP, LV pump, VA-ECMO, ECPELLA, ASD and VSD with native-versus-device flow.Opens with Severe LV failure on VA-ECMO (LV distension)
- Structural interventionsValve repair, drainage and shunt closure: immediately after versus remodelled.Opens with Aortic stenosis, severe (compensated)
MeasurementWhat the catheter records and when it misleads.1
Prefer guidance? Learn walks through one question at a time, and Practice gives you a patient to work up.