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Heart Failure (Compensatory Mechanisms, Counterregulatory Mechanisms…

- - - - AKA HFrEF
      - Normal EF is 55-60%.
        HFrEF: <45%
        Caused by impaired contractile function (MI), increased after load (HTN), cardiomyopathy, and mechanical abnormalities (valvular heart disease)
      - Over time, LV becomes dilated and hypertrophied.
    - - AKA HFpEF
      - Risk factors: elderly, female, diabetes, gender
      - Accounts for about 50% of HF patients
      - LV is stiff and noncompliant. Inability of the ventricles to relax ad fill during diastole
      - Diagnosed by:
        S/S of HF
        Normal EF
        Evidence of LV diastolic dysfunction via echocardiography or cardiac cath.
      - Therapies:
        Targeted at <risk factors and tx co-morbidities
    - - Extremely low EFs <35%
        High pulmonary pressures
        Biventricular failure
      - Ventricular failure of any kind presents with: <CO, <BP, and poor renal perfusion
      - Seen with diseases like DCM (dilated cardiomyopathy)
        
        Poor systolic function further compromised by dilated LV that is unable to relax
      - Poor exercise and heart dysrhythmias common
      - May occur:
        Acutely: MI
        Chronically:
        Worsening cardiomyopathy
        HTN