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Congestive Heart Failure And Its Treatment (Lecture 19)
HEART FAILURE IS WHEN THE HEART IS UNABLE TO SUPPLY ENOUGH BLOOD TO KEEP UP
WITH THE OXYGEN DEMAND, THIS CAN RESULT IN MYOCARDIAL INFARCTIONS ETC
CLASSIFICATION SCHEMES FOR CHRONIC HEART FAILURE:You can divide them up according to whether it is the left or right side of the heart that is failing.
You can also classify them according to whether they are "forward" or "backward"
Another way of classifying the disorder would be to think about whether it is a problem with contraction (systolic) or relaxation (diastolic).
CONGESTIVE HEART FAILURE - FORWARDS AND
The forward symptoms of left ventricular congestive heart failure are caused by a failure to supply the body with sufficient blood.
Forward symptoms arise because of low output.
Backward symptoms arise because of failure to return blood to the heart adequately.
The problems in the lungs are left-sided backward symptoms.
The oedema in the rest of the body is a right sided backward symptom.
The right sided failure often occurs as a consequence of left sided failure. ENLARGEMENT OF THE HEART:As well as ischaemic myopathy e.g. following a heart attack, heart failure can occur as a result of enlargement of the heart.
When the muscle thickness increases this is termed hypertrophy.
When the chambers enlarge, this is termed dilated cardiomyopathy.
In both cases the pumping efficiency of the heart will decrease. A decreased ejection fraction (systolic dysfunction) is more common in dilated myopathy.
FRANK-STARLING CURVE:-Congestive heart failure is a syndrome resulting from chronically impaired contractility of the heart
Common genetic causes include:
à Myocardial Ischaemia
à Valvular Disease
Patients with heart failure have a curve with a lower maximum that is shifted to the right.
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