The pumping attributes of the heart remain active topics of investigation and mastery of how the heart functions as a pump is part of the fund of knowledge of physiologists and cardiologists. The advent of high-resolution, real-time imaging (computed tomography, magnetic resonance imaging cardiac catheterization, two- and three-dimensional echocardiography) has continued to advance our understanding of how the four-chambered heart (left heart, right heart) works as it fills and as it empties. The insights that have evolved emanate from a conceptual framework based on motion (kinematics) of selected phases and portions of the four-chambered heart and the contents of the pericardial sac. Concepts include pressure pumping, volume pumping, constant-volume pumping, the relationship between atrial and ventricular function and atrial and ventricular indexes, the role of the heart as a suction pump, laws that govern isovolumic relaxation, and the relationship of intraventricular fluid mechanics to diastolic function and wall motion. Accordingly, by asking such questions as ‘What is the ejection fraction of the pericardial sack, and why does it have the numerical value it has?’ or ‘Why does the left atrium fill in two phases—one in systole and one in diastole?’ or ‘How is atrial conduit volume related to diastolic wall motion?’ one can gain new insights into pumping function. This chapter presents a simple, useful, yet powerful conceptual framework that can be used descriptively or mathematically to addresses these and other clinically important themes.