山东大学基础医学院：《病理生理学 Pathophysiology》课程PPT教学课件（7年制）10 Heart Failure 心力衰竭

Heart Failure Department of Pathophysiology Zhang Xiao-ming

Heart Failure Department of Pathophysiology Zhang Xiao-ming

Clinical example 病史:患者,女,40岁,风湿性心脏病 史10余年。近3月来出现劳累后心慌、闷 气,伴浮肿、腹胀,不能平卧 A体查:重病容,半坐卧位,颈静脉怒张,呼 吸36次/分,两肺底可闻湿性罗音。心界 向左右两侧扩大,心率130次/分,血压 (11080mmHg)

病史：患者，女，40岁，风湿性心脏病 史10余年。近3月来出现劳累后心慌、闷 气，伴浮肿、腹胀，不能平卧。 体查：重病容, 半坐卧位, 颈静脉怒张, 呼 吸36次/分, 两肺底可闻湿性罗音。心界 向左右两侧扩大, 心率130次/分, 血压 (110/80mmHg) 。 Clinical example

心尖部可闻Ⅳ级收縮期吹风样及舒张期 雷呜样杂音。肝脏在右肋下6cm可触及, 有压痛,腹部有移动性浊音,骶部及下 肢明显凹陷性水肿

心尖部可闻IV级收缩期吹风样及舒张期 雷鸣样杂音。肝脏在右肋下6cm可触及， 有压痛，腹部有移动性浊音，骶部及下 肢明显凹陷性水肿

1. Basic Concepts 2. Causes 3. Classification of heart failure 4. Pathogenesis of heart failure &25 5. Compensatory mechanisms in heart failure sA 2 6.Functional and metabolic alterations 7. Treatment principles

1. Basic Concepts 2. Causes 3. Classification of heart failure 4. Pathogenesis of heart failure 5. Compensatory mechanisms in heart failure 6. Functional and metabolic alterations 7. Treatment principles

1. Basic Concepts (1) Heart failure (2) Cardiac insufficiency (3)Congestive heart failure

1. Basic Concepts (1) Heart failure (2) Cardiac insufficiency (3) Congestive heart failure

From Upper Body To Upper Body o Lu TO From Lung Right Atrium Left Atrium Tricuspid Valve Mitral valve Left Ventricle Right ventricle From Lower Body To Lower Body

Heart failure is the pathological process in which the systolic or/and diastolic function of the heart is impaired, and as a result, cardiac output decreases and is unable to meet the metabolic demands of the bod

Heart failure is the pathological process in which the systolic or/and diastolic function of the heart is impaired, and as a result, cardiac output decreases and is unable to meet the metabolic demands of the body

(2) cardiac insufficiency include compensatory stage and decompensatory stage

(2) cardiac insufficiency include compensatory stage and decompensatory stage

(3)Congestive heart failure is a kind of chronic hf with expansion of blood volume HF with increased volume and fluid accumulated in the lungs, abdominal organs(especially the liver)and 类 AN peripheral tissues

(3) Congestive heart failure is a kind of chronic HF with expansion of blood volume. HF with increased volume and fluid accumulated in the lungs, abdominal organs (especially the liver) and peripheral tissues

Prey到lnce 1996WHO survey: Incidence rate men>women 2-year mortality rate 6-year mortality rate American 2 to 3 million 400.000 new cases

Prevalance 2 to 3 million 400,000 new cases 1996 WHO survey: Incidence rate 1.9% men>women 2-year mortality rate 37% 6-year mortality rate 82% American: