2. Types of heart failure
Systolic heart failure
Diastolic heart failure
Right ventricular heart failure
Left ventricular heart failure
High out put heart failure
Low output heart failure
Acute heart failure
Chronic heart failure
Forward heart failure
Backward heart failure
3. Systolic heart failure
systolic HF is due to the decrease in myocardial
contractility characterized by the decreased ejection
fraction, hence decreases the cardiac output.
Decrease in ejection fraction there is increase in end
diastolic volume(pre load), ventricular wall tension
and raise of pressure in ventricles.
It is commonly results from condition ischemic heart
diseases and cardiomyopathy, hypertension, valvular
stenosis and anemia.
4. Diastolic Heart failure
In this condition heart contract normally but relaxation
is abnormal, hence the ejection fraction is normal but
decrease in ventricular filling ultimately causing
decrease in preload, stroke volume and cardiac
output.
Pulmonary and systemic congestion seen in people
with the dilated poorly contracting heart.
Its chances increases with age.
5. Right ventricular heart failure
Right side heart failure impairs the ability to move
deoxygenated blood from systemic circulation to
pulmonary circulation.
The blood moving to pulmonary circulation is reduced,
hence the blood reached to left side of the heart is
also reduced causing low cardiac out put.
There is accumulation or congestion into systemic
venous system causing edema.
6. Left ventricular heart failure
Due to the left side heart failure the cardiac output
decreases to the systemic circulation, blood
accumulates in the left ventricle, left atrium and
pulmonary circulation, causing elevation in pulmonary
venous pressure.
Lungs develops the pulmonary edema which is most
prominent during night.
Stenosis or regurgitation of the aortic and mitral valve
creates the level of left sided backflow.
7. High output heart failure
It is due to excessive need of cardiac output the
function of the heart maybe supernormal but
inadequate owing to excessive metabolic need.
Severe anemia, thyrotoxicosis and Paget’s disease.
8. Low output heart failure
It is caused by the disorders that impairs the pumping
ability of the heart such as ischemic heart disease.
There is reduction is stroke volume are evidenced by
narrowing of the pulse pressure.
9. Acute heart failure
Sudden and rapid development of heart failure occurs in the following
conditions:
i)Larger myocardial infarction
ii)Valve rupture
iii)Cardiac tamponade
iv)Massive pulmonary embolism
In acute heart failure, there is sudden reduction in cardiac output
resulting in systemic hypotension but oedema does not occur.
Instead, a state of cardiogenic shock and cerebral hypoxia
develops.
10. Chronic heart failure
Progression of acute into chronic failure. In chronic heart failure,
compensatory mechanisms like tachycardia, cardiac dilatation and
cardiac hypertrophy try to make adjustments so as to maintain
adequate cardiac output.
This often results in well-maintained arterial pressure and there is
accumulation of oedema.
Myocardial ischemia from atherosclerosis coronary heart disease,
multivalvular heart disease develop chronic HF.
11. Backward heart failure
According to this concept, either of the ventricles fails
to eject blood normally, resulting in rise of end-
diastolic volume in the ventricle and increase in
volume and pressure in the atrium which is transmitted
backward producing elevated pressure in the veins.
12. Forward heart failure
According to this hypothesis, clinical manifestations
result directly from failure of the heart to pump blood
causing diminished flow of blood to the tissues,
especially diminished renal perfusion and activation of
renin angiotensin-aldosteron system.
