What is heart failure
When the heart is unable to generate a adequate cardiac output causing inadequate perfusion of tissues which is systolic heart failure. Diastolic heart failure is the inability for ventricles to expand
Etiology
Ischemic heart disease- repeated episodes of coronary ischemia lead to multiple MI that affects different area since infarction is permanent damage into many permanent damage is bad
COPD causes right ventricle not to work because COPD leads to a fox you these two construction of pulmonary arteries lease to pulmonary hypertension so Raven is your goal post harder to get blood it’s a pulmonary circulation which then gets tired . Then left side failure happen
What is stroke volume effected by
Preload- amount of blood that enters RA
Afterload- amount of resistance that ventricles must overcome to pump blood out
What influence stroke volume
Cardiac contraction th- ability to stretch
Inotropic- force of contraction increase by the sympathetic respond
Chronotropic- refers to heart rate so meds can bring it down
Starling capillary forces law of the capillaries
Fluid movement is determined by the hydrostatic pressure and osmotic pressure. Hydrostatic pressure push fluid out and osmotic push fluids the interstitial fluid which is in between. Nutrients and oxygen gets pulled out arterial and Venus pull in waste products. So increase hydrostatic increases blood volume coming at the intestinal fluid
What is endothelin
Peptide Release from endothelial cells which increase resistance, stimulate vasoconstriction and causes fibrotic change that is part of remodeling
What does nitric oxide do
Potent vasodilator by vascular endothelial cells that brings BP down
Effects of tumor necrosis factor
Increase in TNF alpha which is pro inflammatory increases hypertrophy, apoptosis and fibrotic changes in endothelium which affect hearts inatropic action which leads to dilation of ventricle with decrease cardiac output