HEART FAILURE

Causes of Heart Failure

Acute myocardial infarction

Hypertension
Degenerative conditions of the heart muscle
known collectively as cardiomyopathies
Excessive work demands (hypermetabolic
states)
Volume overload (renal failure)
Decreased contractility of heart
Damage to the heart valves
Hypo effective heart due to any cause
Congenital heart defects
Constrictive pericarditis
It manifests as either in CO or damming

Manifestations of Heart Failure

High-output or low-output failure

Systolic or diastolic failure
Right-sided or left-sided failure
Acute effects:- CO, damming of blood
leading to systemic. Venous pressure
but within 30 sec. compensated by
symp. Reflexes ( contractility,
vasoconstriction, venoconstriction,
increasing VR & CO
Chronic effects:- Retention of fluid by
kidney, progressive recovery of heart

Heart failure

Right Heart Failure - Represents failure

of the right heart to pump blood
forward into the pulmonary circulation
Blood backs up in the systemic
circulation
Causes peripheral edema and
congestion
of the
abdominalfailure
organsof
Left
heart failure
- Represents
the left heart to move blood from
pulmonary circulation into systemic
circulation

Maintenance of Cardiac Reserve in

Heat Failure

Compensatory or adaptive
mechanisms
Frank-Starling mechanism
Activation of neurohumoral
influences such as the sympathetic
nervous system
The renin-angiotensin-aldosterone
mechanism
Natriuretic peptides

CARDIAC RESERVE

Causes of Right-Sided Heart

Failure

Conditions that restrict blood flow into

the lungs
Stenosis or regurgitation of the
tricuspid or pulmonic valves
Right ventricular infarction
Cardiomyopathy
Persistent left-sided failure
Acute or chronic pulmonary disease
(cor pulmonale)

Causes of Left-Sided Heart

Failure
Acute myocardial infarction
Cardiomyopathy

Signs and Symptoms of Heart

Failure

Fluid retention and edema

Shortness of breath
Fatigue and limited exercise tolerance
Cyanosis
Cachexia and malnutrition
Distention of the jugular veins in rightsided failure
Diaphoresis and tachycardia

Acute Pulmonary Edema

Capillary fluid moves into the
alveoli, causes lung stiffness,
makes lung expansion more
difficult, and impairs the gas
exchange function of the lung
With the decreased ability of the
lungs to oxygenate the blood, the
hemoglobin leaves the pulmonary
circulation without being fully
oxygenated

Systolic stretch in ischemia

Infarction & stages of

recovery

Patent ductus arteriosus

LT. To RT. shunt

Tetrology of Fallot
Rt. To Lt. shunt
Origin of aorta
from rt. Vent.
Stenosis of
pulmonary artery
Blood from lt. to rt.
Vent.
Rt. Vent.
hypertrophy