Heart failure/Repetitorium

Presumed terms : myocardial contractility, blood pressure regulation.

Acute failure
Acute failure (cardiogenic shock) – a sudden, so significant decrease in cardiac output that compensatory mechanisms do not guarantee survival. Immediate therapeutic intervention is necessary.

Causes

 * Extreme changes in frequency (arrest, ventricular fibrillation );
 * Significant decrease in contractility;
 * Tamponade
 * Sudden failure of the valvular apparatus (rupture of the papillary muscle);
 * (Peripheral resistance - sudden increase, pulmonary embolism).

Causes

 * Hypertension – 49%;
 * CHD – 29%;
 * Diabetes – 9%;
 * Valvular defects – 8%.

Consequences
All of the above causes result in a decrease in myocardial contractility, which further causes systolic dysfunction (decrease in Stroke Volume) and diastolic dysfunction (increase in End Diastolic Pressure).

Systolic dysfunction

 * SO;
 * BP;
 * GFR;

→ retention of water and electrolytes, RAS.

Diastolic dysfunction

 * EDP ​​(ventricular compliance);

→ edema.

Molecular Mechanisms

 * Energy;
 * Ca 2+ ;
 * Myocardial remodeling.

Principles of treatment

 * Vasodilatation ;
 * Cardiotonics ;
 * Diuretics.

Related Articles

 * Regulation of blood pressure