prepare me a mind map of cardiac cycle extensively

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~/cardiac-cycle-mindmap/cardiac_cycle_mindmap.html
<!DOCTYPE html>
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<title>Cardiac Cycle - Extensive Mind Map</title>
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  /* ─── WIGGERS DIAGRAM ─── */
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  /* ─── PHASE BANNER ─── */
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</style>
</head>
<body>

<!-- HEADER -->
<div class="page-header">
  <h1>CARDIAC CYCLE</h1>
  <p>Extensive Mind Map &nbsp;|&nbsp; Physiology Reference &nbsp;|&nbsp; Sources: Guyton &amp; Hall, Costanzo, Medical Physiology (Boron &amp; Boulpaep)</p>
</div>

<!-- WIGGERS DIAGRAM -->
<div class="wiggers-section">
  <h2>WIGGERS DIAGRAM — The Complete Cardiac Cycle</h2>
  <img src="https://cdn.orris.care/cdss_images/5379713ae38b7760f16c6d3143e59fb2744f746ac41304bb94abcda6a828d458.png"
       alt="Wiggers Diagram - Cardiac Cycle showing pressure, volume, venous pulse, ECG and heart sounds">
  <p class="wiggers-caption">Fig. A–G: Atrial Systole | Isovolumetric Contraction | Rapid Ejection | Reduced Ejection | Isovolumetric Relaxation | Rapid Filling | Reduced Filling (Diastasis)<br>Source: Costanzo Physiology 7th Edition, Fig. 4.25</p>
</div>

<div class="mindmap-container">

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  1. OVERVIEW                                          -->
  <!-- ══════════════════════════════════════════════════════ -->
  <span class="section-label theme-gold" style="background:transparent;border:2px solid #f0c040;color:#f0c040;">1 — DEFINITION &amp; OVERVIEW</span>
  <div class="card-grid grid-3" style="margin-bottom:10px;">

    <div class="card theme-gold">
      <h3>Definition</h3>
      <ul>
        <li>Sequence of mechanical + electrical events from one heartbeat to the next</li>
        <li>Duration = <strong>60 ÷ Heart Rate (beats/min)</strong></li>
        <li>At HR 72 bpm → <strong>0.833 s/beat</strong></li>
        <li>At HR 75 bpm → <strong>0.8 s (800 ms)</strong></li>
        <li>Applies similarly to left &amp; right ventricles; pressures differ</li>
      </ul>
    </div>

    <div class="card theme-gold">
      <h3>Initiation</h3>
      <ul>
        <li>Spontaneous AP in <strong>sinoatrial (SA) node</strong></li>
        <li>SA node: superior lateral wall of right atrium near SVC</li>
        <li>AP travels → both atria → AV node</li>
        <li><strong>&gt;0.1 s delay</strong> at AV node (atria contract before ventricles)</li>
        <li>Atria = <em>primer pumps</em>; ventricles = main power source</li>
      </ul>
    </div>

    <div class="card theme-gold">
      <h3>Two Broad Phases</h3>
      <ul>
        <li><strong>Systole</strong> — ventricular contraction + ejection</li>
        <li><strong>Diastole</strong> — ventricular relaxation + filling</li>
        <li>At HR 72: systole ≈ <strong>0.4×</strong> total cycle; diastole ≈ 0.6×</li>
        <li>At 3× HR: systole ≈ <strong>0.65×</strong> total cycle</li>
        <li>Fast HR → diastole shortened most → incomplete filling</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  2. VALVES — ANATOMY + MECHANICS                      -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-orange" style="background:transparent;border:2px solid #ffa657;color:#ffa657;">2 — CARDIAC VALVES</span>
  <div class="card-grid grid-4" style="margin-bottom:10px;">

    <div class="card theme-orange">
      <h3>AV Valves (Inlet)</h3>
      <ul>
        <li><strong>Tricuspid</strong> — right AV; 3 cusps</li>
        <li><strong>Mitral (bicuspid)</strong> — left AV; 2 cusps</li>
        <li>Allow flow: atria → ventricles only</li>
        <li>Open passively when upstream &gt; downstream pressure</li>
        <li>Close passively when downstream &gt; upstream pressure</li>
      </ul>
    </div>

    <div class="card theme-orange">
      <h3>Semilunar Valves (Outlet)</h3>
      <ul>
        <li><strong>Pulmonary valve</strong> — RV → pulmonary artery</li>
        <li><strong>Aortic valve</strong> — LV → aorta</li>
        <li>Both have <strong>3 cusps</strong></li>
        <li>Allow flow: ventricles → great vessels only</li>
        <li>Passive opening/closing via pressure gradients</li>
      </ul>
    </div>

    <div class="card theme-orange">
      <h3>Valve Opening Events</h3>
      <ul>
        <li>Mitral opens → start rapid ventricular filling (F)</li>
        <li>Aortic opens → start rapid ejection (C)</li>
        <li>Valve movements detectable by <strong>echocardiography</strong></li>
        <li>Opening snap = pathological (stenotic mitral)</li>
      </ul>
    </div>

    <div class="card theme-orange">
      <h3>Valve Closing Events</h3>
      <ul>
        <li>Mitral closes → <strong>S1</strong> (start IVC, phase B)</li>
        <li>Aortic closes → <strong>S2</strong> (start IVR, phase E)</li>
        <li>Dicrotic notch / incisura on aortic pressure trace = aortic valve closure</li>
        <li>Murmurs from stenosis or regurgitation (turbulence 180–500 Hz)</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  3. SEVEN PHASES OVERVIEW BANNER                      -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-blue" style="background:transparent;border:2px solid #58a6ff;color:#58a6ff;">3 — SEVEN PHASES OF THE CARDIAC CYCLE</span>

  <div class="phase-banner">
    <div class="phase-slot slot-A">A<br>Atrial<br>Systole</div>
    <div class="phase-slot slot-B">B<br>Isovolumetric<br>Contraction</div>
    <div class="phase-slot slot-C">C<br>Rapid<br>Ejection</div>
    <div class="phase-slot slot-D">D<br>Reduced<br>Ejection</div>
    <div class="phase-slot slot-E">E<br>Isovolumetric<br>Relaxation</div>
    <div class="phase-slot slot-F">F<br>Rapid<br>Filling</div>
    <div class="phase-slot slot-G">G<br>Reduced<br>Filling<br>(Diastasis)</div>
  </div>

  <!-- Detailed phase cards -->
  <div class="card-grid grid-2">

    <div class="card theme-blue">
      <span class="badge" style="background:#7cc8ff;color:#000;">A — ATRIAL SYSTOLE (~0–0.1 s)</span>
      <h3>Atrial Contraction</h3>
      <ul>
        <li><strong>ECG:</strong> P wave → PR interval (atrial depolarization)</li>
        <li>Left atrial pressure rises → blood pushed into LV through open mitral valve</li>
        <li>Final (active) phase of ventricular filling</li>
        <li>At rest: atrial kick ≈ <strong>&lt;20%</strong> of stroke volume (can reach 40% on exercise)</li>
        <li>Ventricular volume at its highest (end-diastolic volume reached)</li>
        <li><strong>S4</strong> (fourth heart sound) if present — atrium contracting against stiff ventricle</li>
        <li>JVP: <strong>a wave</strong> = atrial contraction</li>
        <li>Aortic pressure slowly declining as blood runs off periphery</li>
      </ul>
    </div>

    <div class="card theme-blue">
      <span class="badge" style="background:#bc8cff;color:#000;">B — ISOVOLUMETRIC VENTRICULAR CONTRACTION (~0.1–0.2 s)</span>
      <h3>IVC</h3>
      <ul>
        <li><strong>ECG:</strong> QRS complex (ventricular depolarization)</li>
        <li>LV pressure rises sharply; exceeds LA pressure → <strong>mitral valve closes</strong></li>
        <li>LV pressure not yet &gt; aortic pressure → aortic valve still closed</li>
        <li><strong>All valves closed</strong> → no volume change (isovolumetric)</li>
        <li>Ventricular volume constant = <strong>End-Diastolic Volume (EDV)</strong> ≈ 120–130 mL</li>
        <li><strong>S1</strong> — closure of mitral (M1) then tricuspid (T1); may be split</li>
        <li>LV pressure rises from ~5 mmHg → ~80 mmHg (approaches aortic diastolic)</li>
        <li>JVP: <strong>c wave</strong> — bulging of tricuspid valve into RA</li>
      </ul>
    </div>

    <div class="card theme-blue">
      <span class="badge" style="background:#56d364;color:#000;">C — RAPID VENTRICULAR EJECTION (~0.2–0.3 s)</span>
      <h3>Maximum Ejection</h3>
      <ul>
        <li><strong>ECG:</strong> ST segment</li>
        <li>LV pressure exceeds aortic pressure → <strong>aortic valve opens</strong></li>
        <li>Blood rapidly ejected from LV into aorta (most of SV ejected here)</li>
        <li>Ventricular pressure reaches its <strong>maximum</strong> (~120 mmHg)</li>
        <li>Aortic pressure rises rapidly (peak systolic ~120 mmHg)</li>
        <li>Ventricular volume drops sharply</li>
        <li>LA starts filling from pulmonary veins; LA pressure slowly rises</li>
        <li>Aortic flow peaks at onset of this phase</li>
      </ul>
    </div>

    <div class="card theme-blue">
      <span class="badge" style="background:#ffa657;color:#000;">D — REDUCED VENTRICULAR EJECTION (~0.3–0.45 s)</span>
      <h3>Slower Ejection</h3>
      <ul>
        <li><strong>ECG:</strong> T wave (ventricular repolarization begins)</li>
        <li>Ventricles begin to repolarize → pressure falls</li>
        <li>Aortic valve still open → blood continues ejecting (slower rate)</li>
        <li>Ventricular volume reaches minimum = <strong>End-Systolic Volume (ESV)</strong> ≈ 50–60 mL</li>
        <li>Aortic pressure starts to fall (blood running off to periphery faster than ejected)</li>
        <li>LA pressure continues to rise as pulmonary venous return continues</li>
        <li>JVP: <strong>v wave</strong> builds as venous filling of RA continues with tricuspid closed</li>
      </ul>
    </div>

    <div class="card theme-blue">
      <span class="badge" style="background:#ff7b72;color:#000;">E — ISOVOLUMETRIC VENTRICULAR RELAXATION (~0.45–0.5 s)</span>
      <h3>IVR</h3>
      <ul>
        <li><strong>ECG:</strong> After T wave (ventricles fully repolarized)</li>
        <li>LV pressure falls rapidly; drops below aortic pressure → <strong>aortic valve closes</strong></li>
        <li>Dicrotic notch / <strong>incisura</strong> on aortic pressure trace marks aortic closure</li>
        <li><strong>All valves closed</strong> → no volume change (isovolumetric)</li>
        <li>Ventricular volume constant at ESV</li>
        <li><strong>S2</strong> — closure of aortic (A2) then pulmonary (P2); physiological splitting on inspiration</li>
        <li>Splitting: inspiration → ↑ venous return → prolonged RV ejection → P2 delayed</li>
        <li>LV pressure falls from ~80 → ~5 mmHg</li>
      </ul>
    </div>

    <div class="card theme-blue">
      <span class="badge" style="background:#39d3d3;color:#000;">F — RAPID VENTRICULAR FILLING (~0.5–0.65 s)</span>
      <h3>Passive Early Filling</h3>
      <ul>
        <li><strong>ECG:</strong> Silent interval (between T and next P)</li>
        <li>LV pressure falls below LA pressure → <strong>mitral valve opens</strong></li>
        <li>Blood rushes from LA into LV passively (driven by pressure gradient)</li>
        <li>~70–75% of ventricular filling occurs here</li>
        <li>Ventricular volume rises rapidly; pressure stays low (high compliance)</li>
        <li><strong>S3</strong> — rapid inflow causes vibration; normal in children; <span class="pill pill-path">pathological</span> in adults → volume overload (CHF)</li>
        <li>JVP: <strong>y descent</strong> — RA empties into RV as tricuspid opens</li>
        <li>Aortic pressure continues falling as blood runs off</li>
      </ul>
    </div>

  </div>

  <!-- Diastasis card full width -->
  <div class="card theme-blue" style="margin-top:16px;">
    <span class="badge" style="background:#8b949e;color:#000;">G — REDUCED VENTRICULAR FILLING / DIASTASIS (~0.65–0.8 s)</span>
    <h3>Diastasis</h3>
    <ul style="columns:2;column-gap:30px;">
      <li>Mitral valve still open; minimal flow from LA to LV</li>
      <li>Ventricular volume rises very slowly toward a plateau</li>
      <li>LA and LV pressures equalize (near-identical, both very low)</li>
      <li>Pressure in both chambers driven by pulmonary venous pressure (slightly higher)</li>
      <li>Atrial pressure parallels ventricular pressure (small gradient, open valve)</li>
      <li>P wave marks atrial excitation at end of diastasis → cycle repeats (Phase A)</li>
      <li>No heart sounds normally heard during diastasis</li>
      <li>Aortic pressure continues slow decline throughout</li>
    </ul>
  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  4. SUMMARY TABLE                                     -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-blue" style="background:transparent;border:2px solid #58a6ff;color:#58a6ff;">4 — PHASE SUMMARY TABLE</span>

  <div style="overflow-x:auto;">
  <table class="styled-table">
    <thead>
      <tr>
        <th>Phase</th>
        <th>State</th>
        <th>ECG</th>
        <th>Mitral</th>
        <th>Aortic</th>
        <th>LV Volume</th>
        <th>LV Pressure</th>
        <th>Heart Sound</th>
        <th>JVP</th>
      </tr>
    </thead>
    <tbody>
      <tr class="phase-a">
        <td>A — Atrial Systole</td>
        <td>LA contraction</td>
        <td>P wave, PR</td>
        <td>Open</td>
        <td>Closed</td>
        <td>↑ to EDV</td>
        <td>↑ slightly</td>
        <td>S4 (if heard)</td>
        <td>a wave</td>
      </tr>
      <tr class="phase-b">
        <td>B — Isovolumetric Contraction</td>
        <td>Both valves closed</td>
        <td>QRS</td>
        <td>Closes (S1)</td>
        <td>Closed</td>
        <td>Constant (EDV)</td>
        <td>↑↑ rapidly</td>
        <td>S1</td>
        <td>c wave</td>
      </tr>
      <tr class="phase-c">
        <td>C — Rapid Ejection</td>
        <td>Ejection (fast)</td>
        <td>ST segment</td>
        <td>Closed</td>
        <td>Opens</td>
        <td>↓↓ rapidly</td>
        <td>↑ to peak (~120)</td>
        <td>—</td>
        <td>—</td>
      </tr>
      <tr class="phase-d">
        <td>D — Reduced Ejection</td>
        <td>Ejection (slow)</td>
        <td>T wave</td>
        <td>Closed</td>
        <td>Open</td>
        <td>↓ to ESV</td>
        <td>↓ from peak</td>
        <td>—</td>
        <td>v wave builds</td>
      </tr>
      <tr class="phase-e">
        <td>E — Isovolumetric Relaxation</td>
        <td>Both valves closed</td>
        <td>After T</td>
        <td>Closed</td>
        <td>Closes (S2)</td>
        <td>Constant (ESV)</td>
        <td>↓↓ rapidly</td>
        <td>S2 (dicrotic notch)</td>
        <td>—</td>
      </tr>
      <tr class="phase-f">
        <td>F — Rapid Filling</td>
        <td>Passive filling (fast)</td>
        <td>Silent</td>
        <td>Opens</td>
        <td>Closed</td>
        <td>↑↑ rapidly</td>
        <td>Low, constant</td>
        <td>S3 (if heard)</td>
        <td>y descent</td>
      </tr>
      <tr class="phase-g">
        <td>G — Diastasis</td>
        <td>Passive filling (slow)</td>
        <td>Silent → P</td>
        <td>Open</td>
        <td>Closed</td>
        <td>↑ slowly</td>
        <td>Very low</td>
        <td>—</td>
        <td>—</td>
      </tr>
    </tbody>
  </table>
  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  5. PRESSURES                                         -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-teal" style="background:transparent;border:2px solid #3fb950;color:#3fb950;">5 — KEY PRESSURES (Left Heart)</span>

  <div class="card-grid grid-3">

    <div class="card theme-teal">
      <h3>Left Ventricular Pressure</h3>
      <ul>
        <li>Diastole (filling): <strong>~5–12 mmHg</strong></li>
        <li>Start of IVC: ~5 mmHg</li>
        <li>Peak systolic: <strong>~120 mmHg</strong></li>
        <li>During IVR: drops rapidly to ~5 mmHg</li>
        <li>LV pressure MUST exceed aortic pressure to open aortic valve</li>
        <li>LV pressure MUST fall below aortic to allow aortic closure</li>
      </ul>
    </div>

    <div class="card theme-teal">
      <h3>Aortic Pressure</h3>
      <ul>
        <li>Diastolic: <strong>~80 mmHg</strong></li>
        <li>Peak systolic: <strong>~120 mmHg</strong></li>
        <li>Pulse pressure = systolic − diastolic = ~40 mmHg</li>
        <li><strong>Dicrotic notch (incisura)</strong>: brief rise then fall at aortic valve closure</li>
        <li>Aortic pressure continuously declines during diastole (run-off)</li>
        <li>Mean aortic pressure drives coronary perfusion</li>
      </ul>
    </div>

    <div class="card theme-teal">
      <h3>Left Atrial Pressure</h3>
      <ul>
        <li>Very low throughout (~5–12 mmHg)</li>
        <li><strong>a wave</strong> — atrial contraction (Phase A)</li>
        <li>During systole: LA fills slowly from pulmonary veins</li>
        <li><strong>v wave</strong> — LA filling with mitral closed (Phases C–E)</li>
        <li><strong>x descent</strong> — atrial relaxation + downward displacement of mitral annulus</li>
        <li><strong>y descent</strong> — mitral opens → LA empties</li>
        <li>Pulmonary capillary wedge pressure (PCWP) ≈ LA pressure in clinic</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  6. VOLUMES & CALCULATIONS                            -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-purple" style="background:transparent;border:2px solid #bc8cff;color:#bc8cff;">6 — VOLUMES &amp; DERIVED CALCULATIONS</span>

  <div class="card-grid grid-3">

    <div class="card theme-purple">
      <h3>Key Volume Values</h3>
      <ul>
        <li><strong>EDV (End-Diastolic Volume)</strong> = ~120–140 mL</li>
        <li><strong>ESV (End-Systolic Volume)</strong> = ~50–70 mL</li>
        <li><strong>Stroke Volume (SV)</strong> = EDV − ESV = ~70 mL</li>
        <li>RV EDV = 70–100 mL (similar to LV)</li>
        <li>Cardiac output of RV = LV (in steady state)</li>
      </ul>
    </div>

    <div class="card theme-purple">
      <h3>Ejection Fraction (EF)</h3>
      <ul>
        <li>EF = SV ÷ EDV</li>
        <li>Normal: <strong>≥55%</strong> (typically ~55–70%)</li>
        <li>Reflects <strong>contractility</strong></li>
        <li>↑ EF = positive inotropic effect</li>
        <li>↓ EF = negative inotropic effect (e.g., HFrEF &lt;40%)</li>
      </ul>
      <div class="formula-box">
        <div class="label">Formula</div>
        EF = SV / EDV<br>
        EF = (140 − 70) / 140 = 0.50 (50%)
      </div>
    </div>

    <div class="card theme-purple">
      <h3>Cardiac Output (CO)</h3>
      <ul>
        <li>CO = SV × Heart Rate</li>
        <li>Normal: <strong>~5,000 mL/min</strong> (70 mL × 72 bpm)</li>
        <li>Cardiac Index = CO / BSA = 2.5–4 L/min/m²</li>
        <li>Increases during exercise via ↑ SV + ↑ HR</li>
      </ul>
      <div class="formula-box">
        <div class="label">Formula</div>
        CO = 70 mL × 72 bpm<br>
        CO ≈ 5,040 mL/min
      </div>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  7. HEART SOUNDS                                      -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-red" style="background:transparent;border:2px solid #ff7b72;color:#ff7b72;">7 — HEART SOUNDS</span>

  <div class="card-grid grid-4">

    <div class="card theme-red">
      <h3>S1 — "Lub"</h3>
      <ul>
        <li>Closure of <strong>mitral + tricuspid</strong> valves</li>
        <li>Marks start of <strong>systole</strong> (IVC, Phase B)</li>
        <li>Mitral (M1) closes slightly before tricuspid (T1)</li>
        <li>May be physiologically split</li>
        <li>Dominant frequencies: <strong>110–180 Hz</strong></li>
        <li>Best heard: <strong>apex</strong> with bell</li>
      </ul>
    </div>

    <div class="card theme-red">
      <h3>S2 — "Dub"</h3>
      <ul>
        <li>Closure of <strong>aortic + pulmonary</strong> valves</li>
        <li>Marks start of <strong>diastole</strong> (IVR, Phase E)</li>
        <li>Aortic (A2) closes before pulmonary (P2)</li>
        <li><strong>Physiological splitting</strong> on inspiration</li>
        <li>Inspiration → ↑ venous return → prolonged RV ejection → delayed P2</li>
        <li>Wide fixed split → ASD; Paradoxical split → LBBB/AS</li>
      </ul>
    </div>

    <div class="card theme-red">
      <h3>S3 — "Ken-tuck-y"</h3>
      <ul>
        <li>Rapid ventricular filling (Phase F)</li>
        <li><span class="pill pill-normal">Normal</span> in children &amp; young adults</li>
        <li><span class="pill pill-path">Pathological</span> in adults &gt;40 yrs</li>
        <li>Indicates: <strong>volume overload</strong> — CHF, MR, TR</li>
        <li>Best heard at apex in left lateral decubitus with bell</li>
        <li>"Ventricular gallop"</li>
      </ul>
    </div>

    <div class="card theme-red">
      <h3>S4 — "Ten-nes-see"</h3>
      <ul>
        <li>Atrial contraction against stiff ventricle (Phase A)</li>
        <li>Never <span class="pill pill-normal">normal</span> in adults</li>
        <li>Indicates: ↓ ventricular compliance — LVH, HCM, HTN, AS, MI</li>
        <li>"Atrial gallop" or "presystolic gallop"</li>
        <li>Best heard: apex with bell in left lateral position</li>
        <li>Opening Snap (OS): stenotic mitral valve opening</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  8. ECG CORRELATION                                   -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-cyan" style="background:transparent;border:2px solid #39d3d3;color:#39d3d3;">8 — ECG CORRELATION</span>

  <div class="card-grid grid-3">

    <div class="card theme-cyan">
      <h3>P Wave &amp; PR Interval</h3>
      <ul>
        <li><strong>P wave</strong> = atrial depolarization</li>
        <li>Marks onset of Atrial Systole (Phase A)</li>
        <li>PR interval = AV nodal conduction delay (&gt;0.1 s)</li>
        <li>P wave occurs at end of diastasis (Phase G) → Phase A begins</li>
      </ul>
    </div>

    <div class="card theme-cyan">
      <h3>QRS Complex</h3>
      <ul>
        <li>Ventricular depolarization</li>
        <li>Marks onset of <strong>IVC</strong> (Phase B)</li>
        <li>Q wave = septal depolarization (L → R)</li>
        <li>R wave = main ventricular depolarization</li>
        <li>S wave = basal ventricular depolarization</li>
        <li>Mechanical systole begins shortly after QRS onset</li>
      </ul>
    </div>

    <div class="card theme-cyan">
      <h3>ST Segment &amp; T Wave</h3>
      <ul>
        <li><strong>ST segment</strong> = ventricular plateau (rapid ejection, Phase C)</li>
        <li>ST elevation/depression → ischemia</li>
        <li><strong>T wave</strong> = ventricular repolarization</li>
        <li>Onset of T = reduced ejection (Phase D)</li>
        <li>End of T = ventricles fully repolarized → IVR begins (Phase E)</li>
        <li>After T → silent → next P wave (diastasis, Phase G)</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  9. JUGULAR VENOUS PULSE (JVP)                        -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-indigo" style="background:transparent;border:2px solid #7c7cff;color:#7c7cff;">9 — JUGULAR VENOUS PULSE (JVP)</span>

  <div class="card-grid grid-2">

    <div class="card theme-indigo">
      <h3>JVP Waveforms</h3>
      <ul>
        <li><strong>a wave</strong> — atrial contraction (Phase A); precedes S1</li>
        <li><strong>c wave</strong> — tricuspid valve bulging into RA during IVC; coincides with S1</li>
        <li><strong>x descent</strong> — atrial relaxation + downward displacement of tricuspid annulus during systole</li>
        <li><strong>v wave</strong> — venous filling of RA with tricuspid closed (systole, Phases C–E)</li>
        <li><strong>y descent</strong> — tricuspid opens → RA empties into RV (rapid filling, Phase F)</li>
      </ul>
    </div>

    <div class="card theme-indigo">
      <h3>Clinical Significance</h3>
      <ul>
        <li>Large a wave → <strong>RV hypertrophy</strong>, tricuspid stenosis, heart block</li>
        <li>Absent a wave → <strong>atrial fibrillation</strong></li>
        <li>Large v wave → <strong>tricuspid regurgitation</strong>, RV failure</li>
        <li>Kussmaul sign: JVP rises on inspiration → constrictive pericarditis, RV failure</li>
        <li>Elevated JVP → right heart failure, fluid overload, SVC obstruction</li>
        <li>Normally observed in internal jugular vein (not external)</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  10. FRANK-STARLING & REGULATION                      -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-pink" style="background:transparent;border:2px solid #f778ba;color:#f778ba;">10 — FRANK-STARLING LAW &amp; REGULATION OF CARDIAC OUTPUT</span>

  <div class="card-grid grid-3">

    <div class="card theme-pink">
      <h3>Frank-Starling Law</h3>
      <ul>
        <li>SV ejected depends on <strong>EDV</strong> (end-diastolic volume)</li>
        <li>EDV depends on venous return (preload)</li>
        <li>↑ Venous return → ↑ EDV → ↑ sarcomere stretch → ↑ force → ↑ SV</li>
        <li>Ensures: <strong>CO = Venous Return</strong> in steady state</li>
        <li>Physiologic range = nearly linear; high EDV → curve flattens</li>
        <li>Exercise → EDV can rise to 40% contribution from atrial kick</li>
      </ul>
    </div>

    <div class="card theme-pink">
      <h3>Contractility (Inotropism)</h3>
      <ul>
        <li><strong>Positive inotropes</strong> → shift Frank-Starling curve upward</li>
        <li>Examples: catecholamines, digoxin, Ca²⁺, glucagon</li>
        <li>Result: ↑ SV &amp; ↑ EF for same EDV</li>
        <li><strong>Negative inotropes</strong> → shift curve downward</li>
        <li>Examples: beta-blockers, Ca²⁺ channel blockers, acidosis, hypoxia</li>
        <li>Result: ↓ SV &amp; ↓ EF for same EDV</li>
      </ul>
    </div>

    <div class="card theme-pink">
      <h3>Preload, Afterload &amp; HR</h3>
      <ul>
        <li><strong>Preload</strong> = ventricular wall stress at end of diastole ≈ EDV/filling pressure</li>
        <li>↑ Preload (↑ venous return, fluid loading) → ↑ SV</li>
        <li><strong>Afterload</strong> = resistance ventricle must overcome = systemic vascular resistance (SVR)</li>
        <li>↑ Afterload (↑ SVR, aortic stenosis) → ↓ SV, ↑ ESV</li>
        <li><strong>Heart Rate</strong>: ↑ HR → ↑ CO (but ↓ diastolic filling time)</li>
        <li>Positive chronotropy = ↑ HR (sympathetics, atropine)</li>
        <li>Negative chronotropy = ↓ HR (vagus, beta-blockers)</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  11. PRESSURE-VOLUME LOOP                             -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-green" style="background:transparent;border:2px solid #56d364;color:#56d364;">11 — VENTRICULAR PRESSURE-VOLUME LOOP</span>

  <div class="card-grid grid-2">

    <div class="card theme-green">
      <h3>The P-V Loop (Normal)</h3>
      <ul>
        <li>Plots LV pressure (y-axis) vs. LV volume (x-axis) throughout the cycle</li>
        <li><strong>Point 1 (lower right)</strong>: mitral opens → filling begins (EDV = 120–140 mL)</li>
        <li><strong>Point 2 (upper right)</strong>: IVC — mitral closes; pressure rises at constant volume</li>
        <li><strong>Point 3 (upper left)</strong>: aortic opens → ejection; volume falls, pressure rises to peak</li>
        <li><strong>Point 4 (lower left)</strong>: aortic closes → IVR; ESV = 50–70 mL; pressure falls</li>
        <li>Loop width = stroke volume</li>
        <li>Loop area = stroke work done by ventricle</li>
      </ul>
    </div>

    <div class="card theme-green">
      <h3>P-V Loop Shifts</h3>
      <ul>
        <li>↑ Preload → wider loop (↑ EDV, ↑ SV), loop shifts rightward</li>
        <li>↑ Afterload → narrower loop (↓ SV, ↑ ESV), loop shifts leftward/upward</li>
        <li>↑ Contractility → loop shifts toward upper left (↑ SV, ↓ ESV, ↑ EF)</li>
        <li>Heart failure → loop shifts right + smaller area (↓ SV, ↓ EF)</li>
        <li>ESPVR (end-systolic P-V relationship) = slope = measure of contractility</li>
        <li>Steeper ESPVR slope = higher contractility</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  12. CLINICAL CORRELATES                              -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-amber" style="background:transparent;border:2px solid #e3b341;color:#e3b341;">12 — CLINICAL CORRELATES</span>

  <div class="card-grid grid-3">

    <div class="card theme-amber">
      <h3>Effect of Heart Rate on Cycle</h3>
      <ul>
        <li>↑ HR → all phases shorten; <strong>diastole shortened most</strong></li>
        <li>At very high HR: incomplete filling → ↓ CO</li>
        <li>Tachycardia → ↓ diastolic filling time → ↓ coronary perfusion time</li>
        <li>Very fast AF/flutter → ventricular function impairs</li>
        <li>Bradycardia → ↑ diastolic filling → ↑ EDV → ↑ SV (Frank-Starling)</li>
      </ul>
    </div>

    <div class="card theme-amber">
      <h3>Valvular Pathology</h3>
      <ul>
        <li><strong>Mitral stenosis</strong>: ↓ LV filling; opening snap replaces mitral opening; LA hypertension</li>
        <li><strong>Mitral regurgitation</strong>: blood leaks back to LA during systole; ↑ LA v wave; pansystolic murmur</li>
        <li><strong>Aortic stenosis</strong>: ↑ afterload; ↑ IVC time; ejection systolic murmur; LVH</li>
        <li><strong>Aortic regurgitation</strong>: blood leaks to LV in diastole; ↑ EDV; wide pulse pressure; diastolic murmur</li>
      </ul>
    </div>

    <div class="card theme-amber">
      <h3>Common Pathological Patterns</h3>
      <ul>
        <li><strong>Heart failure (HFrEF)</strong>: ↓ EF, ↓ SV, ↑ ESV, S3 gallop, ↑ JVP</li>
        <li><strong>Hypertrophic cardiomyopathy</strong>: S4, diastolic dysfunction, ↓ compliance</li>
        <li><strong>Pericardial tamponade</strong>: ↑ pericardial pressure → ↓ EDV → ↓ CO → pulsus paradoxus</li>
        <li><strong>Constrictive pericarditis</strong>: Kussmaul sign; prominent y descent; pericardial knock (early S3)</li>
        <li><strong>Atrial fibrillation</strong>: loss of a wave on JVP; no S4; variable SV</li>
      </ul>
    </div>

  </div>

  <!-- ══════════════════════════════════════════════════════ -->
  <!--  13. RIGHT vs LEFT COMPARISON                         -->
  <!-- ══════════════════════════════════════════════════════ -->
  <div class="divider"></div>
  <span class="section-label theme-teal" style="background:transparent;border:2px solid #3fb950;color:#3fb950;">13 — RIGHT HEART vs LEFT HEART COMPARISON</span>

  <div style="overflow-x:auto;">
  <table class="styled-table">
    <thead>
      <tr>
        <th>Parameter</th>
        <th>Left Ventricle</th>
        <th>Right Ventricle</th>
      </tr>
    </thead>
    <tbody>
      <tr>
        <td>Inlet valve</td>
        <td>Mitral (bicuspid, 2 cusps)</td>
        <td>Tricuspid (3 cusps)</td>
      </tr>
      <tr>
        <td>Outlet valve</td>
        <td>Aortic (3 cusps)</td>
        <td>Pulmonary (3 cusps)</td>
      </tr>
      <tr>
        <td>Peak systolic pressure</td>
        <td>~120 mmHg</td>
        <td>~25 mmHg</td>
      </tr>
      <tr>
        <td>Diastolic pressure</td>
        <td>~5–12 mmHg</td>
        <td>~0–8 mmHg</td>
      </tr>
      <tr>
        <td>Stroke volume</td>
        <td>~70 mL</td>
        <td>~70 mL (identical in steady state)</td>
      </tr>
      <tr>
        <td>Wall thickness</td>
        <td>Thick (~10 mm)</td>
        <td>Thin (~3 mm)</td>
      </tr>
      <tr>
        <td>Ejection fraction</td>
        <td>≥55%</td>
        <td>≥45% (slightly lower acceptable)</td>
      </tr>
      <tr>
        <td>Timing of valve closure</td>
        <td>M1 before T1 (S1); A2 before P2 (S2)</td>
        <td>T1 slightly after M1; P2 delayed on inspiration</td>
      </tr>
    </tbody>
  </table>
  </div>

  <!-- SOURCE NOTE -->
  <div class="source-note">
    Sources: Guyton &amp; Hall Textbook of Medical Physiology (9780443111013) | Costanzo Physiology 7th Ed (9780323793339) | Medical Physiology — Boron &amp; Boulpaep (9780323319737)
  </div>

</div><!-- /mindmap-container -->

</body>
</html>
Running Command
ls -lh /home/daytona/workspace/cardiac-cycle-mindmap/
Your extensive cardiac cycle mind map is ready:
cardiac cycle mindmap
HTML File · HTML
Here's what the mind map covers across 13 detailed sections, built from Guyton & Hall, Costanzo Physiology 7th Ed, and Medical Physiology (Boron & Boulpaep):
What's Inside

1 - Definition & Overview The cycle = all mechanical + electrical events from one beat to the next. Duration = 60 ÷ HR. At 72 bpm = 0.833 s. Initiated by SA node AP; AV nodal delay >0.1 s lets atria contract first.
2 - Cardiac Valves AV valves (mitral, tricuspid) vs semilunar (aortic, pulmonary). All 4 open/close passively by pressure gradients. Murmurs arise from stenosis or regurgitation (turbulence 180-500 Hz).
3 - Seven Phases (Costanzo classification)
Phase	Name	Duration
A	Atrial Systole	0-0.1 s
B	Isovolumetric Contraction (IVC)	0.1-0.2 s
C	Rapid Ventricular Ejection	0.2-0.3 s
D	Reduced Ventricular Ejection	0.3-0.45 s
E	Isovolumetric Relaxation (IVR)	0.45-0.5 s
F	Rapid Ventricular Filling	0.5-0.65 s
G	Diastasis	0.65-0.8 s
Each phase has: ECG event, valve status, LV pressure + volume change, heart sound, and JVP correlate.
4 - Full Phase Summary Table - all parameters at a glance.
5 - Key Pressures - LV (5→120 mmHg), Aortic (80→120 mmHg, dicrotic notch), LA (a/v waves, x/y descents).
6 - Volumes & Calculations
EDV ~120-140 mL, ESV ~50-70 mL, SV ~70 mL
EF = SV/EDV = ~55%, CO = SV × HR = ~5 L/min
7 - Heart Sounds - S1 (mitral/tricuspid closure), S2 (aortic/pulmonary closure + splitting on inspiration), S3 (rapid filling, pathological in adults = CHF), S4 (stiff ventricle = LVH/HCM).
8 - ECG Correlation - P wave/PR/QRS/ST/T wave mapped to each phase.
9 - JVP Waveforms - a, c, x-descent, v, y-descent; clinical interpretation.
10 - Frank-Starling & Regulation - preload, afterload, contractility, inotropes, chronotropy.
11 - Pressure-Volume Loop - normal loop anatomy + shifts with preload/afterload/contractility changes.
12 - Clinical Correlates - tachycardia effects, valve pathology, HFrEF, HCM, tamponade, AF.
13 - Right vs Left Heart Comparison - pressures, wall thickness, valve names, EF ranges.
The Wiggers diagram from Costanzo is embedded at the top of the file for visual reference.
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