2. HEART
FAILURE
It occurs when heart is unable to
pump blood that is adequate for the
needs of tissues.
Causes : decreased myocardial
contractility, increased pressure or
volume overload.
Physiological alterations:
decreased stroke volume (forward
failure), damming of blood in venous
compartment (backward failure)
3. TYPES OF
HEART FAILURE
โข Acute failure and chronic failure
โข Left sided failure and right sided failure
โข High output and low output failure
โข Forward and backward failure
โข Systolic and diastolic failure
5. Pressure overload
โข Causes ventricular systolic dysfunction
โข Increased blood pressure increases
afterload
โข Early stage: increased afterload results in
concentric hypertrophy of ventricles
โข Functional capacity of ventricle depends
on stress exerted on ventricles.
6. โข Stage of Compensation: wall stress normalizes due to increase in wall thickness and
decrease in cavity radius.
โข Stage of hypertrophy and dilation: ventricular stress increases due to proportionate
increase in radius caused by dilation which leads to systolic failure.
7. Volume overload
โข Increased venous Return, DBP increases
โข Chamber enlargement results in eccentric hypertrophy.
โข EARLY STAGE: Stage of Dilation
8. โข STAGE OF ECCENTRIC HYPERTROPHY: stress normalizes
โข STAGE OF FURTHER DILATION: dilation exceeds hypertrophy
9. CLINICAL FEATURES
โข DYSPNEA- breathlessness
โข In Early stage: Dyspnea occur during exercise
โข In advanced stage: dyspnea occurs even at rest
โข ORTHOPNEA: dyspnea in recumbent position (redistribution of blood, pushed
diaphragm)
โข PAROXYSMAL NOCTURNAL DYSPNEA: Episodes of dyspnea and cough of sudden
onset in nights
โข Partly due to depression of respiratory centers and partly due to accumulation of excess
fluid in the lungs
10. โข EDEMA IN THE DEPENDENT PARTS:
โข HEPATOMEGALY
โข INCREASED JUGULAR VENOUS PRESSURE
โข ASCITES
