This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: AIIMS 2018, Subject name: Physiology
During exercise in physiological limits what is the effect on end systolic volume? 
Select and explain. 
A. ESV decreases, B. ESV increase, C. ESV remain unchanged, D. ESV first decrease and then increases
A: ESV decreases
Answer: A: ESV decreases 
Explanation: During exercise, there is increased sympathetic discharge and venous return to hea. This causes increased stroke volume mainly due to increased myocardial contractility. Due to increased stroke volume, the ESV decreases. In the image given the stoke volume is indicated by the width of the loop and LV pressure by the height of the loop. Three major effects occurring during exercise are : Sympathetic nervous system activation in many tissues with stimulatory effects on circulation. Increase in aerial pressure Increase in cardiac output.