Heart failure

Congestive Heart Failure with systolic and diastolic dysfunction of the heart. Features of right and left heart failure is also added.

1. Congestive Heart Failure Prepared by: Anish Dhakal (Aryan) [email protected] MBBS Student Patan Academy of Health Sciences

2. Objectives To clarify the congestive heart failure along with its causes

3. Congestive Heart Failure pathophysiologic state impaired cardiac function is unable to maintain an adequate circulation for the metabolic needs of the tissues of the body

4. Congestive Heart Failure Systolic dysfunction (Intrinsic Pump failure) Diastolic dysfunction (Impaired filling) Increased Workload on Heart

5. Systolic dysfunction Pumping is possible only at higher than normal end-diastolic pressure Forward failure & Backward failure Also can be caused by: High oxygen demand Poor oxygen carrying capacity

6. Systolic dysfunction Ischemic Heart Disease Systemic Hypertension Valve dysfunction (stenosis) Myocardium diseases (myocarditis , cardiomyopathies) Disorder of the rhythm (atrial fibrillation and flutter)

7. Diastolic dysfunction Cardiac tamponade ( Haemopericardium , Hydropericardium ) Constrictive pericarditis

8. Increased Workload to the Heart In pressure overload states: Increase in wall thickness, chamber size same In volume overload states: Chambers dilate, wall thickness may be normal or altered

9. Physiology of Increased Workload In healthy heart: Frank-Starling mechanism cause increased C.O. overcoming decreased pressure governed by Laplace law In CHF even when blood volume is more & hypertrophy present ,ejected blood is low In addition myocardial oxygen demand elevates

10. Left & Right Heart Failure Left Heart failure caused by: Ischemic Heart Disease Systemic Hypertension Valve dysfunction (stenosis) Myocardium diseases (myocarditis , cardiomyopathies) Right heart failure by LHF and cor pulmonale