Pathophysiology Diagram Of Congestive Heart Failure

Risk Factors: • Hypercholesterolemia • Men (>45 years old) • Women (>55 years old) • Cigarette smoking • Alcoholism • Diabetes mellitus • Obesity • Physical inability

• •

↑ sodium intake* Hereditary*

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Predisposing Factors: • Hypertension*

•

CAD*

Genetic predisposit ion cell membrane alteration functional vasoconstri ction

↑ peripher al HPN (↑ BP) Vasoconstrictio n of blood vessels

↑

Vasoconstricti on of coronary arteries

afterloa

↑

Increase pressure of blood flow

workloa d

↑ force of

Injury of the endothelial vessel layer (coronary Vessel damage Monocytes, platelets,cholesterol and other blood Scarrin g

LV contractio

↑ stress on the left ventricular

↑ cardiac output

Left ventricular Hypertroph Ventricular remodeling

LV Hypoxia

↓ Brain

Atherosclerosis

perfusion: dizziness, light headedness, confusion, anxiety, restlessness . ↓Response to energy demands causing easily

CA D ↓ cardiac

tissue blood flow

↓ cardiac muscle contraction

{

Activation of baroreceptors in the LV, aortic

↑ catecolami nes (epinephrin

↑ residual blood of the LV at the time of diastole ↑ LV pressure

↓ Cardiac

blood backflows from LV to

↓ Systemic

↑ residual blood of the LA during diastole

Output

blood pressure

Stimulation of vasomotor regulatory centers in Activation of sympathetic nervous system

↓ left ventricular

↓ Perfusion of

↑ LA pressure

tissues of the body

↓GFR

↓

blood returns to pulmonary circulation

Renal Proteinu ria, ↑ urea (8.0), ↓ crea

Reni formation of Angiotensi Angiotensin

Accumulation of blood in the pulmonary capillary bed (Lung s) ACE

Hypothala ADH

Sodium and Water retention

↓ urine

↓ urine

↑osmo tic pressu

↑osmo tic pressu Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea

Pulmonary edema: dyspnea, cough, crackles, 2 pillow orthopnea

HR

↑ pulmonary vascular resistance

↓O2 saturation

↑ RV contract ↑ force of RV contractio ↑ RV oxygen demand

RV ↓ force of RV contractio

↑ residual blood of the RV at the time of ↑ RV blood backflows from RV to

Peripheral edema, liver congestion, ascites, weakness, weight gain due

↑ fluid moves into the interstitial

↑ RA ↑ RA

↑ venous pressure JVD (07/24/08)

blood backflows from RA to