Professional Documents
Culture Documents
Definition
Etiology
Cardiomyopathies (primary
myocardial disease )
Ischemic heart disease
Haemodynamic overload
Arrhythmias
In fact any severe heart disease is
possible to evolute towards heart
failure syndrome
Pathology
myocardial cells
performance of existing myocites
Pathophysiology
Pathogenesis
Adaptation mechanisms I
Hypertrophy
Dilatation
heart rate (tachycardia)
contractility (notfunctionning)
Adaptation mechanisms II
peripheral A +V O2 extraction
Redistribution of cardiac output
peripheral vasoconstriction
blood volume and of venous return
( Na and H2O retention)
Realised through:
Cathecolamines
RAA system
Congestive syndrom
Lungs: - dyspnea,
- rales,
- dullness,
- pleural effusion
Liver:
- hepathomegaly
- tenderness
Peripheral edema
Ascites, pleural effusion, pericardial effusion
(rare)
Venous distention : jugular hepatojugular reflux
Cyanosis: - peripheral
- central
Weakness, fatigue
Pallor
weight
Oliguria
SBP DBP
Cerebral symptoms
Investigations
Echocardiography
- LV, RV or both
- contractility
- LA, RA or both
- LVEF, RVEF or both
- PAPs
- MR, TR
- diastolic LV dysfunction:
- abnormal relaxation
- pseudonormalisation
- restriction
Rx (chest x ray)
cardiac chambers
Cardiothoracic ratio >0,55
Pulmonary congestion
Pulmonary arterial hypertension
Pleural effusion
ECG
- always abnormal
Morphologycal abnormalities
- of the underlying disease
- necrosis
- hypertrophy
- arrhythmias:
- atrial fibrillation
- ventricular: PVB, VT,
- sinus tachycardia
Rare investigations
Cardiac angiography
Coronarography
Myocardial biopsy
MRI
CT multislice
Biochemical date
BNP, ANP
Lipids
Liver function tets
Glycemia
Ions: Na, K
Creatinine
Haematocrit
TREATMENT
TREATMENT
TREATMENT
ulmonary Edem
Pulmonary
edema is a condition
characterized by fluid accumulation in the
lungs caused by back pressure in the lung
veins. This results from malfunctioning of
the heart.
Pulmonary
edema is a complication of a
myocardial infarction (heart attack), mitral
or aortic valve disease, cardiomyopathy, or
other disorders characterized by cardiac
dysfunction.
Fluid
Extreme
Restlessness
Cough
Excessive
Pale
sweating
skin
Nasal flaring
Coughing up blood
Breathing, absent temporarily
Listening
Blood
An