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Heart failure (6 Mechanisms (Obstruction to flow (Lesions to prevent valve…

- - - - Backward of blood flow
        
        Increased volume workload to affected chambers
  - - - Divert blood inapproriately
  - - - Arrythmias
    - - Decrease contraction frequency
        
        Low cardiac output
  - - - Chambers cannot empty properly (Systolic Dysfunction)
- - - - Doesnt meed metabolic demand
        
        Hypoperfusion
      - (Backward failure) Increase end diastolic volume
        
        Increase diastolic pressure
        
        Elevated venous pressure
        
        Increase congestion of venous circulation
      - Compensated Heart Failure
        
        Increase wall tension
        
        Increase Oxygen requirements of compensated myocardium
        
        If prolonged will cause insufficient oxygen supply
        
        Ischaemic Heart Disease Decompensated Heart Failure
  - - - Hyperthyroidism
    - - Anaemia
  - - - Increase end diastolic filling volume
        
        Dilate heart
        
        Increase cardiac myofibre stretching
        
        Contract more forcibly to increase cardiac output
    - - Increase Norepinephrine
        
        Increase Heart Rate
      - Activate RAAS
        
        Salt and water retention
        
        Increase Blood Volume
        
        Increase vascular tone
      - Stimulate ANP
        
        Balance RAAS by diuresis and vascular smooth muscle relaxation
    - - Cardiac muscle cannot proliferate but can increase workloads
        
        Pressure overload (Ex: HTN/ Valvular stenosis)
        
        New sacromeres added parallel to long axis of existing sacromeres
        
        Concentric hypertrophy (Ventricular thickness increase without increase in size of chamber)
        
        Volume overload (EX: Valvular regurgitation/shunts)
        
        Increase new sacromeres added series to existing sacromeres
        
        Ventricle dilate
        
        Wall thickness either increase/decrease/normal
        
        Compensatory hypertrophy
        
        2 more items...
  - - - Gross
        
        LVH
        
        Mitral insuffiiciency and left atrial enlargement
        
        Atrial fibrillation (No distinct P wave)
      - Microscopic
        
        Myocyte hypertrophy and interstitial fibrosis
      - Morphology of lung
        
        Gross
        
        Lungs are heavy and boggy
        
        Microscopic
        
        Perivascular and interstital transudates
        
        Alveolar septa oedema (Accumulation of edema fluid in alveolar spaces)
        
        Red cells extravasated from the leaky capillaries into alveolar spaces,
        
        Phagocytosed by macrophage
        
        1 more item...
    - - Diminised systemic perfusion
        
        Elevated back pressures to pulmonary circulaition
        
        Increase pulmonary vein pressure
        
        Pleural effusion due to increase hydrostatic pressure