Pathophysiology Diagram of Congestive Heart Failure

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Risk Factors: Hypercholesterolemia Men (>45 years old) Women (>55 years old) Cigarette smoking Alcoholism Diabetes mellitus Obesity Physical inability sodium intake* Hereditary* Predisposing Factors: Hypertension* CAD*

Genetic predispositi on cell membrane alteration functional vasoconstri ction

peripher al HPN ( BP)


Vasoconstrictio n of blood vessels

Vasoconstricti on of coronary arteries Increase pressure of blood flow Injury of the endothelial vessel layer (coronary artery) Vessel damage Monocytes, platelets,cholesterol and other blood Scarrin g

afterloa

workloa d

force of
LV contractio

stress on
the left ventricular cardiac output Left ventricular Hypertroph Ventricular remodeling LV Hypoxia

Atherosclerosis

Brain
perfusion: dizziness, light headedness, confusion, anxiety, restlessness. Response to energy demands causing easily fatigued,

left ventricular residual blood


of the LV at the time of diastole

CA D cardiac
tissue blood flow

cardiac
muscle contraction Activation of baroreceptors in the LV, aortic

LV pressure
blood backflows from LV to

Cardiac
Output

Systemic
blood pressure

Stimulation of vasomotor regulatory centers in Activation of sympathetic nervous system catecolamin es (epinephrin

residual blood of the LA during diastole LA pressure


blood returns to pulmonary circulation Accumulation of blood in the pulmonary capillary bed

Perfusion of
tissues of the body

GFR

Renal
Proteinu ria, urea (8.0), crea (41.),

Reni formation of Angiotensi Angiotensin

(Lung s) ACE

Hypothalam ADH Sodium and Water retention Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea

urine urine
osmot ic pressu

osmot ic output pressu Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea

HR

pulmonary vascular resistance RV contracti force of RV contractio RV oxygen demand

O2 saturation

RV force of RV contractio

residual
blood of the RV at the time of RV blood backflows from RV to RA RA

Peripheral edema, liver congestion, ascites, weakness, weight gain due

fluid moves
into the interstitial

venous
pressure JVD (07/24/08)

blood backflows from RA to

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