文档介绍：Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
By
Nik Nikam, .
Interventional Cardiologist
Sugar Land Tefect
interleukins &TNF
May have roles in myocyte hypertrophy
Apoptosis
Endothelin
Vasoconstriction VR
After load
Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
Cardiovascular physiology
Frank-Starling
Length: Tension Ratio
Ejection Fraction
End diastolic volume/end systolic volume
Cardiac Output
Stroke volume x heart rate
Preload
Volume of blood delivered to heart during diastole
Afterload
Peripheral vascular resistance
Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
• Volume overload: Regurgitate valve
High output status
• Pressure overload: Systemic hypertension
Outflow obstruction—AS
• Loss of muscles: Post MI, Chronic ischemia
Connective tissue diseases
Infection, Poisons (alcohol,cobalt,Doxorubicin)
• Restricted Filling: Pericardial diseases,
Restrictive cardiomyopathy
Tachyarrhythmia
Causes of CHF
Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
Types of CHF
Systolic & Diastolic
High Output Failure
Pregnancy, anemia, thyrotoxicosis, A/V fistula, Beriberi, Pagets disease
Low Output Failure
Acute
large MI, aortic valve dysfunction---
Chronic
Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
Types of CHF
Right v. Left sided heart failure
Right sided heart failure :
Most common cause is left sided failure
Other causes included : Pulmonary embolisms
Other causes of pulmonary HTN
RV infarction
MS
Usually presents with: LL edema, ascities
Hepatic congestion
Cardiac cirrhosis (on the long run)
Congestive Heart Failure CHF
SUGAR LAND
HEART CENTER
New York Heart Association (NYHA) Functional Classification
Class
% of pts
Sy