Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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Table of Contents
Year : 2021  |  Volume : 24  |  Issue : 1  |  Page : 118-119
Lessons from the frank-starling curve

Department of Anaesthesia, PGIMER, Chandigarh, India

Click here for correspondence address and email

Date of Submission23-Jan-2020
Date of Decision01-Mar-2020
Date of Acceptance01-Mar-2020
Date of Web Publication22-Jan-2021

How to cite this article:
Bloria SD. Lessons from the frank-starling curve. Ann Card Anaesth 2021;24:118-9

How to cite this URL:
Bloria SD. Lessons from the frank-starling curve. Ann Card Anaesth [serial online] 2021 [cited 2022 Jan 27];24:118-9. Available from:

To the Editor,

The Frank-Starling curve is a very basic and important concept in medicine. First described by Otto Frank and Ernest Starling, the curve demonstrates how the stroke volume (volume of blood ejected from the left ventricle every heartbeat) varies with the preload (the amount of blood reaching heart from veins).

As a first-year MBBS student, I memorized these words from “Guyton and Hall Textbook of Medical Physiology”—”the Frank-Starling mechanism means that the greater the heart muscle is stretched during filling, the greater the force of contraction and the greater the quantity of blood pumped into the aorta” and learnt to draw the accompanying diagram [Figure 1]. My seniors had told me that this was a sure shot question for both theory and viva, and I did not wish to lose out on some easy marks, which were otherwise rather difficult to get, thanks to strict teachers and my somewhat “ordinary” memory.
Figure 1: Frank-Starling curve

Click here to view

I also remember teaching the basics of the Frank-Starling curve to my friend that extra stretching of cardiac muscles by incoming blood brings actin and myosin filaments inside cardiac muscles to a more optimal degree of overlap, causing better contraction of cardiac muscles.

As I look at the Frank-Starling curve today after about 15 years, I wonder whether there was something more, that the curve wanted me to learn, something that I ignored. It was not a medical lesson, but a way to conduct my life. And I think I am not alone, the world around is filled with people constantly chasing dreams, running day and night, and putting more and more efforts to fulfill those dreams.

While correlating the curve with our life, I cannot help but wonder if the x-axis in the curve were our efforts, and y-axis were the results what we should expect in every aspect of life. In this regard, maybe the curve wanted us to know that our output will increase with more efforts only to one extent, and putting further efforts will lead to dissatisfaction and worsen the results. And while we put all our efforts into one aspect of life, the other aspects remain neglected. Maybe giving equal importance to our professional and personal lives will give us more satisfied and fulfilling lives.

Physician burnout and depression rates are high at all times.[1] Remarkably, it has been questioned whether suicide has become an occupational hazard for physicians.[2] Although the need for better systems in place to counter “workplace stressors” for physicians has been stressed, maybe the best way of leading happier lives would be changing our perceptions and goals. Though we have read medicine, maybe we still need to read and understand the secret to successful lives. And the answer is around us, we just need to recognize it.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

Kuhn CM, Flanagan EM. Self-care as a professional imperative: Physician burnout, depression and suicide. Can J Anaesth 2017;64:158-68.  Back to cited text no. 1
Vogel L. Has suicide become an occupational hazard of practising medicine? CMAJ 2018;190:E752-3.  Back to cited text no. 2

Correspondence Address:
Summit D Bloria
C/O 3245/15D, PGIMER, Chandigarh - 160 012
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aca.ACA_29_20

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  [Figure 1]