WEEK: LECTURE: 1 HEART DISORDERS HEART FAILURE (CHF ) Also known as congestive heart Failure and results in the the heart not being able to pump enough blood (reduced cardiac output) and the heart Fails to perform its Function of perusing the body tissue and organs with blood. Characterised by pooling of blood in the venous system as the heart cannot pump sufficiently and develops gradually with a Few cases manifesting acutely. The heart adopts to this by the myocardium hypertrophying (thickenedand/or heart chambers dilating (cardiomegaly) CHF - LEFT-SIDED HEART FAILURE (LHF) Heart Failure that affects the left side of the heart CAUSES Ischaemic heart disease (IHD) Myocardial infarction (MI) Systemic hypertension (long term elevated BP causing hypertrophy) Difficulty breathing while laying down (orthopnoea) Mitral or aortic valve dysfunction (regurgitation of blood/impaired cardiac output) CLINICAL MANIFESTATIONS CLINICAL FEATURES shortness of breath (dyspnoea) Cough Latt heart talite Decreased cardiac output| |Pulmonary congestion Activity Pumonan Rettunga and signs a peration Orhoppas Gymnose and signs of Increased heart rate ( tachycardia) Cough wn Bubbling/rattling sounds in lungs (rales) Head and arms Jugular vein (also CO subclavian wein from arms) Carotid artery (also cubelavian artery bo arme When the left side of the heart Fails, blood starts pooling up in the lungs as the oxygenated blood returns through the left side of the heart which has Failed and is unable to pump causing blood to pool into the left atrium, pulmonary veins then eventually the lungs . This build up of blood/Fluid in the lungs leads to pulmonary congestion creating pulmonary hypertension. Eventually as the right side of the lungs has to pump harder to pump blood into the lungs causing hypertrophy and eventually right-sided heart Failure Backwards effect Pulmonary artery Lungs Aorta Pulmonary vein Superior vena cava CO. O Inferior vena cava- Hepatic vein Heart Mosenteric arteries Liver Digestive tract Hepatic portal vein Reral artery Henal vein- Kidneys lliac artery CO Trunk and legs B C Lungs are filled with fluid blood - pulmonary oedema . Alveolar walls have + RBC congestion Clear alveoli in the lungs . normal no Alvid or blood in the lungs Forward Effect Frothy transudate that has been forced out by the lungs Unable to pump as much blood to the aorta causing reduced cardiac output resulting in the rest of the body getting less blood supply including the kidneys. This reduced renal perfusion activates RAAS as they think BP has dropped and increases bp and pushes more blood to the left Side of the heart Furthering the problem.