• G Recordati.
• Istituto di Clinica Medica Generale e Terapia Medica, Università degli Studi e Ospedale Maggiore, Milano. giorgio.recordati@unimi.it
• Cardiologia. 1999 Sep 1; 44 (9): 783-9.

AbstractHemodynamics stands on three main physical principles: the hydrostatic pressure, firstly described by Stevino, the viscous flow pressure, described by Poiseuille and the total hydraulic energy, or Bernoulli's equation. However, neither of these physical principles gives a comprehensive description of the single pressure measurement in the cardiovascular system. Hence, all these principles should be used together to fully describe the physical forces acting in the circulation of blood. Experiments that measured the hydrostatic pressure in the jugular vein of the giraffe have shown that a few guidelines need to be followed to measure it correctly. Following these guidelines, it can be seen that hydrostatic and viscous flow pressures are strictly related to one another, and that this relationship is described in mathematical terms. In addition, it has been shown that hydrostatic and viscous pressures should be included in Bernoulli's principle, to give the combined Bernoulli-Poiseuille equation. This unified principle is helpful not only to measure correctly the pressure with a catheter connected to a pressure transducer, but also to give to the pressure measured in a patient with the mercury manometer, a strong connection with the description of the pressure as a physical force acting inside the circulation. In addition it provides a comprehensive view of the cardiovascular system as a closed hydrodynamic system, in which the heart is a pump, that does not normally work to overcome the force of gravity. The question at this point is: are there any pathophysiological conditions in which the heart needs to be confronted with the sudden appearance of the force of gravity inside the cardiovascular system?

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