Pathophysiology of heart failure
Definition
- HF = failure to deliver output adequate for metabolic demand, or to do so only at the cost of elevated filling pressures
- Two mechanically distinct problems, frequently coexisting:
- Systolic - impaired ejection; dilated, eccentrically hypertrophied ventricle
- Diastolic - impaired relaxation (active, ATP-dependent) and compliance; concentric hypertrophy, stiff ventricle
- Forward failure (dec output: fatigue, hypotension, renal hypoperfusion) vs backward failure (congestion: dyspnoea, oedema)
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