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Afterload of the heart is when there is tension or stress that is placed on the wall of the left ventricle when blood is being pushed out of the heart. This can cause too much blood to build up in the heart at any given time. Preload of the heart is when there is tension or stress placed on the right ventricle of the heart when blood is taken into the heart. This can mean that not enough blood is being pumped into the heart as needed. The effects of preload of the heart can lead to poor circulation and lower blood pressure.

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Q: What is the difference between the effects of preload and afterload on the heart?
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Do angiotensin II blockers affect preload or afterload?

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What effect does Sodium Nitroprusside have on afterload and preload?

It decreases preload and afterload as a result of the dilation in the venous and arterial vasculature from the nitric oxide.


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A change in cardiac output without any change in the heart rate, pulmonary artery wedge pressure (PAWP = equated to preload) or systemic vascular resistance (SVR = afterload) would have to be due to a change in the contractility of the heart. Cardiac output (CO) is roughly equal to stroke volume x heart rate. Stroke volume is related to preload, contractility, and afterload. As you can see, the only variables you have not controlled for is cardiac contractility.


How can stroke volume can be altered?

Stroke volume is determined by three factors, altering any of them can change the stroke volume. These factors are preload, afterload, and contractility. The relationship is: SV = P*C/A What this means is that preload and contractility are directly proportional to the stroke volume and afterload is inversely proportional to stroke volume. If you increase preload (within certain limits), stroke volume will increase according to the Starling curve. Increasing contractility (many things can increase this), makes the heart pump harder and increases stroke volume. Increasing afterload decreases stroke volume. All of these can be reversed (decreasing preload and contractility = decreased stroke volume, etc). Get a good physiology book and it will explain all of this very well.


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John is about to preload his truck with logs.


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