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congestive heart failure pathophysiology

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pathophysiology of congestive heart failure

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congestive heart failure pathophysiology

  1. 1. Depressed ejection fraction (<40%) -coronary heart dse -hypertention -chronic volume overload. Preserved ejection fraction (>40-50%) -aging Pulmonary heart disease -cor pulmonale -pulmonary vascular dis -pathologic hypertrophy -restrictive cardiomyopathy -fibrosis High-output states -thyrotoxicosis -beri-beri -chronic anemia -systemic arteriovenous Injury to the heart muscle Loss of function of cardiac myocytes Dec. ability of the myocardium to Generate force Dec cardiac contractility Dec SV Dec CO (s/sx: dec exercise tolerance) “Unloading” of high pressure baroreceptors in carotid sinus & aortic arch Efferent sympathetic nervous system Ant-lat portion of upper medula Stimulate cardiac regulatory center in the pons & medulla arginine vasopressin (ADH) from posterior pituitary Vasoconstriction of blood vessels Vasoconstriction Inc the permeability of the renal collecting ducts Renal hypoperfusion Release of rennin Converts angiotensinogen to angiotensin I ACE converts angiotensin I to angiotensin II Vasoconstriction of the peripheral vasculature
  2. 2. aldosterone Reabsorbtion of water& electrolyte Transcriptional and posttranscriptional changes in the genes and proteins Inc afterload, Excessive beta activation 1 Inc force of contractility Inc preload (2025mmHg) Inc cardiac output (via compensation) Inc heart rate s/sx: tachycardia LV End systolic vol inc Inc in pulmonary capillary pressure Pulmonary congestion (s/sx: DOB) From prolate ellipsoid to spherical shape Remodeling of LV Leakage of Ca Dec diastolic filling Papillary msc r pulled apart dyspnea Incomp of mitral valve Inc wall stress of LV Mitral regurgitation LV wall thining Afterload mismatch Further dec SV Dec CO HEART FAILURE Stiffning of the ventricles (s/sx: arrhythmias) 1
  • HardikKavar2

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    Nov. 7, 2016

pathophysiology of congestive heart failure

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