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heart failure

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Mohit gohel
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2 views

heart failure

Uploaded by

Mohit gohel
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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definition: a pathophysiology condition on which impaired cardiac function is

unable to maintain an adequate circulation of blood for metabolic needs of tissue


• it can be acute or chronic, congestive heart failure is used for chronic
condition

ETIOLOGY
Could be caused by one of these factors individually or in combination

intrinsic pump failure


Most common and imp cause of chf is weakening of ventricular muscles, due to
which heart fails to pump
Other disease which may culminate in heart failure are ==ischaemic heart dis-
ease== ==Beri beri== ==atrial fibrillation==

increased heart workload


Increased workload on heart results in increased myocardial demand and could
be in form of pressure or volume
1. Pressure load: could occur due to systemic or circulatory hypertension or
valvular disease(mitral stenosis, aortic stenosis), chronic lung disease
2. Volume load: when a ventricle is required to pump more blood than usual,
as seen in severe anemia and hypoxia, valvular insufficiency

impaired filling of cardiac chambers


May occur due extra cardiac defects in filling of heart ==constructive pericardi-
tis== ==Cardiac tamponade==

types of heart failure


Could be acute or chronic, right or left soded, forward or backward

acute and chronic


OTBO of wether the disease develops spontaneously or slowly

acute
Sudden and rapid heart failure occurs in the following condition 1. ==Myocar-
dial infarction== 2. ==Valve rupture== 3. ==Cardiac tamponade==
In acute HF, cardiac output is lowered suddenly resulting in systemic hypoten-
sion, but oedema doesnt occur, instead ==hypoxia occurs==

1
chronic
Due to 1. ==Myocardial ischaemia== 2. ==Multivalvular heart disease== 3.
Arterial hypertension
In CHF, regulatory mechanisms such as tachycardia, vaporization and cardiac
hypertrophy try to regulate the cardiac output, which ==results in oedema==

left and right


Functionally both sides of the heart are different and independent
Clinical manifestation of heart failure results from accumulation of excessive
fluid upstream to upper chambers

left sided
Initiated by stress to the left side Major causes: 1. ==Systemic hypertension==
2. ==Aortic or mitral valve disease== 3. ==Restrictive pericarditis==
left side CHF is bought about due decreased output from left ventricle causing
fluid accumulation in the lungs upstream
Major pathological changes are
• pulmonary congestion and oedema causes dysponea
• decreased output caused hypoperfusion and diminished oxygenation of
tissue, causing tubular necrosis

right sided
It occurs more as a consequence of left sided heart failure, however some condi-
tions affect the RV primarily 1. Consequence of LHF 2. ==Cor pulmonary==
in which RV failure occurs due to intrinsic lung disease 3. Pulmonary valve
disease
Consequences of RHF are upstream, causing systemic or portal venous conges-
tion
pathological changes - systemic venous congestion in tissues and organs, passive
congestion of liver and kidneys, leg veins and neck veins - reduced cardiac output
causing systemic stagnation causing anoxia,cyanosis and coldness of extremities

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