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11.18.08(d): Heart Failure

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Slideshow is from the University of Michigan Medical School's M1 Cardiovascular / Respiratory sequence

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11.18.08(d): Heart Failure

  1. 1. Author(s): Gerald Abrams, M.D., 2009License: Unless otherwise noted, this material is made available under the termsof the Creative Commons Attribution–Non-commercial–Share Alike 3.0License: http://creativecommons.org/licenses/by-nc-sa/3.0/We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize yourability to use, share, and adapt it. The citation key on the following slide provides information about how youmay share and adapt this material.Copyright holders of content included in this material should contact open.michigan@umich.edu with anyquestions, corrections, or clarification regarding the use of content.For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use.Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosisor a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pleasespeak to your physician if you have questions about your medical condition.Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
  2. 2. Citation Key for more information see: http://open.umich.edu/wiki/CitationPolicyUse + Share + Adapt { Content the copyright holder, author, or law permits you to use, share and adapt. } Public Domain – Government: Works that are produced by the U.S. Government. (USC 17 §105) Public Domain – Expired: Works that are no longer protected due to an expired copyright term. Public Domain – Self Dedicated: Works that a copyright holder has dedicated to the public domain. Creative Commons – Zero Waiver Creative Commons – Attribution License Creative Commons – Attribution Share Alike License Creative Commons – Attribution Noncommercial License Creative Commons – Attribution Noncommercial Share Alike License GNU – Free Documentation LicenseMake Your Own Assessment { Content Open.Michigan believes can be used, shared, and adapted because it is ineligible for copyright. } Public Domain – Ineligible: Works that are ineligible for copyright protection in the U.S. (USC 17 § 102(b)) *laws in your jurisdiction may differ { Content Open.Michigan has used under a Fair Use determination. } Fair Use: Use of works that is determined to be Fair consistent with the U.S. Copyright Act. (USC 17 § 107) *laws in your jurisdiction may differ Our determination DOES NOT mean that all uses of this 3rd-party content are Fair Uses and we DO NOT guarantee that your use of the content is Fair. To use this content you should do your own independent analysis to determine whether or not your use will be Fair.
  3. 3. Heart Failure M1 – Cardiovascular/Respiratory Sequence Gerald Abrams, MD Jennifer Matthews, MD Jonathan Haft, MDFall 2008
  4. 4. HEART FAILUREInability of the heart to eject sufficient blood to meet metabolic demands of the body - increased demand - systolic failure - diastolic failure
  5. 5. CAUSES OF HEART FAILURE•  Resistance to flow•  Regurgitant flow•  Myocardial disease•  Conduction abnormality
  6. 6. Hypertensive heartDepartment of Pathology, University of Michigan
  7. 7. Aortic StenosisSource Undetermined
  8. 8. Aortic StenosisDepartment of Pathology, University of Michigan
  9. 9. Mitral StenosisDepartment of Pathology, University of Michigan
  10. 10. Mitral RegurgitationDepartment of Pathology, University of Michigan
  11. 11. Myocardial Ischemic DiseaseDepartment of Pathology, University of Michigan
  12. 12. Myocardial Ischemic DiseaseDepartment of Pathology, University of Michigan
  13. 13. Myocardial Ischemic DiseaseDepartment of Pathology, University of Michigan
  14. 14. MyocarditisG.D. Abrams, University of Michigan Medical School
  15. 15. HemochromatosisG.D. Abrams, University of Michigan Medical School
  16. 16. Hemochromatosis Iron StainG.D. Abrams, University of Michigan Medical School
  17. 17. AmyloidosisG.D. Abrams, University of Michigan Medical School
  18. 18. Hypertrophic CardiomyopathyDepartment of Pathology, University of Michigan
  19. 19. Hypertrophic CardiomyopathyG.D. Abrams, University of Michigan Medical School
  20. 20. Compensatory Mechanisms•  Frank-Starling mechanism•  Myocardial Hypertrophy•  Activation of neurohumoral systems
  21. 21. Myocardial HypertrophyG.D. Abrams, University of Michigan Medical School
  22. 22. Concentric HypertrophyDepartment of Pathology, University of Michigan
  23. 23. Eccentric HypertrophyDepartment of Pathology, University of Michigan
  24. 24. Neurohumoral Mechanisms•  Norepinephrine•  Vasopressin•  Renin-Angiotensin-Aldosterone system•  Natriuretic peptides•  Cytokines
  25. 25. Problems with Hypertrophy•  Adequate perfusion•  Mitochondrial deficiency•  Altered gene expression•  Apoptosis•  Remodeling -unfavorable geometry -fibrosis
  26. 26. Myocardial fibrosisSource Undetermined
  27. 27. Problems with Neurohumoral Activation•  Vasoconstriction…….altered afterload•  Chronic cardiotoxic effects•  Sodium retention – water retention
  28. 28. Consequences of Heart Failure•  “Forward failure”•  “Backward failure”•  Left heart failure•  Right heart failure
  29. 29. H.F. Effects in LiverG.D. Abrams, University of Michigan Medical School
  30. 30. H.F. Effects in LiverDepartment of Pathology, University of Michigan
  31. 31. Ischemic ColitisDepartment of Pathology, University of Michigan
  32. 32. Additional Source Information for more information see: http://open.umich.edu/wiki/CitationPolicySlide 6: Department of Pathology, University of MichiganSlide 7: Source UndeterminedSlide 8: Department of Pathology, University of MichiganSlide 9: Department of Pathology, University of MichiganSlide 10: Department of Pathology, University of MichiganSlide 11: Department of Pathology, University of MichiganSlide 12: Department of Pathology, University of MichiganSlide 13: Department of Pathology, University of MichiganSlide 14: G.D. Abrams, University of Michigan Medical SchoolSlide 15: G.D. Abrams, University of Michigan Medical SchoolSlide 16: G.D. Abrams, University of Michigan Medical SchoolSlide 17: G.D. Abrams, University of Michigan Medical SchoolSlide 18: Department of Pathology, University of MichiganSlide 19: G.D. Abrams, University of Michigan Medical SchoolSlide 21: Source UndeterminedSlide 22: Department of Pathology, University of MichiganSlide 23: Department of Pathology, University of MichiganSlide 26: Source UndeterminedSlide 29: G.D. Abrams, University of Michigan Medical SchoolSlide 30: Department of Pathology, University of MichiganSlide 31: Department of Pathology, University of Michigan

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