How The Heart Works


The normal heart is a strong, hardworking pump made of muscle tissue.

It's about the size of a person's fist.

It pumps blood continuously through the circulatory system. Each day the average heart "beats" (expands and contracts) 100,000 times and pumps about 2,000 gallons of blood. In a 70-year lifetime, an average human heart beats more than 2.5 billion times.

What is the heart's structure?

The heart has four chambers through which blood is pumped. The upper two are the right and left atria. The lower two are the right and left ventricles. Four valves open and close to let blood flow in only one direction when the heart beats:

  • The tricuspid valve is between the right atrium and right ventricle.

  • The pulmonary or pulmonic valve is between the right ventricle and the pulmonary artery.

  • The mitral valve is between the left atrium and left ventricle.

  • The aortic valve is between the left ventricle and the aorta.

Each valve has a set of flaps (also called leaflets or cusps). The mitral valve has two flaps. The others have three. Under normal conditions, the valves let blood flow in just one direction. Blood flow occurs only when there's a difference in pressure across the valves that causes them to open.

How does the heart pump blood?

The heart's four chambers must beat in an organized manner. This is governed by an electrical impulse. A chamber of the heart contracts when an electrical impulse moves across it. Such a signal starts in a small bundle of highly specialized cells in the right atrium -- the sinoatrial  node (SA node), also called the sinus node. A discharge from this natural "pacemaker" causes the heart to beat. This pacemaker generates electrical impulses at a given rate, but emotional reactions and hormonal factors can affect its rate of discharge. This lets the heart rate respond to varying demands.

Dark bluish blood, low in oxygen, flows back to the heart after circulating through the body. It returns to the heart through veins and enters the right atrium. This chamber empties blood through the tricuspid valve (B) into the right ventricle.

The right ventricle pumps the blood under low pressure through the pulmonary valve into the pulmonary artery. From there the blood goes to the lungs where it gets fresh oxygen (C). After the blood is refreshed with oxygen, it's bright red. Then it returns by the pulmonary veins to the left atrium. From there it passes through the mitral valve (D) and enters the left ventricle.

The left ventricle pumps the red oxygen-rich blood out through the aortic valve into the aorta (E). The aorta takes blood to the body's general circulation. The blood pressure in the left ventricle is the same as the pressure measured in the arm.