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Ninja Nerd Heart Failure - Coggle Diagram

- - - - Causes
        
        Reduction in contractility
        
        Myocartial infarction and fibrosis
        
        Dilated cardiomiopathy
        
        Myocarditis
      - Pathophysiology
        
        Can't contract -> Cannot pump blood out
        
        Reduced Left ventricular ejection fraction (the percentage of blood that is pumped out of the heart's left ventricle with each heartbeat)
        
        Reduced Cardiac Output (CO = SV x HR) (L/min) - rate
        BP = CO x SVR
        
        Heart failure with reduced EF (HFrEF) (<40%)
      - Cardiac Remodelling
        
        Dilated left ventrical
    - - Causes
        
        Increased afterload
        
        Chronic Hypertension
        
        Aortic Stenosis
      - Cardiac Remodelling
        
        Left ventricular hypertrophy -> Pushing against high pressure afterload
      - Pathophysiology
        
        Left ventricular hypertrophy due high pressure after load
        
        Smaller left ventrical
        
        Issuw with filling ventricle
        
        Ejection fraction preserved - HFpEF (>40%)
        
        Low cardiac output due to reduced stroke volume
        BP = CO x SVR
  - - - Reduced cardiac output due to heart failure
      - Reduced BP due to reduced CO
      - SVR and CO will have to compensate to maintain BP
      - Low BP activates baroreceptors
      - Sympathetic nervous system activated - NE and E released
      - β1 receptors activated in heart to Increased HR and therefore CO
      - α1 receptors activated in peripheral vasculature causing vasocontriction of arteries and veins to increase SVR and therefore BP
      - Afterload increased due to arterial constriction
      - Left ventricular hypertrophy - worsens diastolic heart failure (HFpEF)
      - Preload increased due to venous contriction
      - Increased dilation of left ventricle - worsens systolic heart failure (HFrEF)
      - BP = CO x SVR
    - - Juxtaglomerular apparatus cells sense decreased renal perfusion / low blood pressure
      - JGA releases renin
      - Renin converts Angiotensinogen → Angiotensin I
      - ACE converts Angiotensin I → Angiotensin II
      - Angiotensin II will
        
        Stimulate Aldosterone release from adrenals
        
        Stimulate SNS
        
        Stimulate arteriolar vasocontriction
        
        Simulate ADH secretion from pituitary
      - Aldosterone increases water and salt retension
      - ADH increases water resorption
      - Increased SVR causing increased Afterload and Preload
        Increased Afterload - worsens LV hypertrophy
        Increased Preload - worsens dilation
      - Increased blood volume
        Oedema
        Dilation
    - - Increased volume in the heart causes stretch
      - ANP released
      - ANP inhibits Angiotensin II
        
        No SNS activation
        
        No Aldosterone release
        
        No arteriolar vasocontriction
        
        No ADH secretion
        
        Prevents increase in blood pressure and volume
- - - - Causes
        
        Deacresed contractility
        
        Myocardial infarction - Right ventricular MI
      - Cardiac Remodelling
        
        Right ventricular dilation
      - Pathophysiology
        
        Dilated RV
        
        Reduced RVCO and RVEF
    - - Cause
        
        *Increased Pulmonary vascular resistance / Pulmonary
        
        Pulmonary hypertension
        
        Idiopathic
        
        Due to LHF
        
        Lung disease / hypoxia
        
        Chronic pulmonary thromboembolic disease
        
        Misc - Metabolic, systemic, haematological disoders
        
        https://d1z8zkw1yi6kd7.cloudfront.net/uploads/ckeditor/pictures/data/000/002/909//content/Classification_of_pulmonary_HTN.jpg
      - Cardiac Remodelling
        
        Right ventricular hypertrophy
      - Pathophysiology
        
        Increased pulmonary resistance leads to hypertrophy of right ventricle
        
        Reduced filling of right ventricle~
        
        Preserved ejection fraction