重庆医科大学：《内科学》课程教学课件（PPT讲稿）HEART FAILURE

http://www.bykeer.com 2005 riki's Nipal HEART FAILURE THE SECOND AFFILIATED HOSPITAL Prof.Luo Kailiang

1 HEART FAILURE THE SECOND AFFILIATED HOSPITAL Prof. Luo Kailiang

1.Definition Heart failure is a complex clinical syndrome,and arises from a process of ventricular dysfunction (acute or chronic), where the venous return to the heart is normal but the heart is unable to pump sufficient blood to meet the body's metabolic needs at normal filling pressures. 2

2 1. Definition Heart failure is a complex clinical syndrome, and arises from a process of ventricular dysfunction (acute or chronic), where the venous return to the heart is normal but the heart is unable to pump sufficient blood to meet the body’s metabolic needs at normal filling pressures

Definition Circulatory failure:an abnormality of some component of the circulation is responsible for the inadequate cardiac output. (heart,the blood volume,the concentration of oxygenated hemoglobin in the arterial blood, or the vascular bed) 3

3 Definition ❖Circulatory failure：an abnormality of some component of the circulation is responsible for the inadequate cardiac output. (heart, the blood volume, the concentration of oxygenated hemoglobin in the arterial blood, or the vascular bed)

2.Epidemiology nearly 500,000 patients with HF for the first time each year. During the last 10 years the annual number of hospitalizations increased from approximately 550,000 to nearly 900,000 for HF as a primary diagnosis ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult(2001) 4

4 2. Epidemiology ◼nearly 500,000 patients with HF for the first time each year. ◼During the last 10 years the annual number of hospitalizations increased from approximately 550,000 to nearly 900,000 for HF as a primary diagnosis ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult(2001)

Nearly 300,000 patients die of HF as a primary or contributory cause each year, and the number of deaths has increased steadily despite advances in treatment. Heart failure is primarily a disease of the elderly.Approximately 6%to 10%of people older than 65 years have HF 5

Nearly 300,000 patients die of HF as a primary or contributory cause each year, and the number of deaths has increased steadily despite advances in treatment. Heart failure is primarily a disease of the elderly. Approximately 6% to 10% of people older than 65 years have HF 5

3.CAUSES OF HEART FAILURE Underlying causes ischemic heart disease Cardiomyopathies and hypertensive heart disease congenital,valvular heard disease 6

6 3. CAUSES OF HEART FAILURE Underlying causes ischemic heart disease Cardiomyopathies and hypertensive heart disease congenital, valvular heard disease

In evaluating patients with HF,it is important to identify not only the underlying but also the precipitating cause.Although a heart disease is already existed,it may be adequately compensated under normal circumstances.The additional load imposed by a precipitating can cause further deterioration of cardiac function

In evaluating patients with HF, it is important to identify not only the underlying but also the precipitating cause. Although a heart disease is already existed, it may be adequately compensated under normal circumstances. The additional load imposed by a precipitating can cause further deterioration of cardiac function

CAUSES OF HEART FAILURE Precipitating causes 1) infections arrhythmias 3 Physical,dietary,fluid,environmental, and emotional Excesses. 4) Acute myocardial infarction 5 Pulmonary Embolism 6) Anemia 7)Thyrotoxicosis 8)Aggravation of Hypertension 9) Inappropriate treatment 10)Cardiac disease becomes severe or other diseases occur 8

8 CAUSES OF HEART FAILURE 1) infections 2) arrhythmias 3) Physical, dietary, fluid, environmental, and emotional Excesses. 4) Acute myocardial infarction 5) Pulmonary Embolism 6) Anemia 7) Thyrotoxicosis 8) Aggravation of Hypertension 9) Inappropriate treatment 10)Cardiac disease becomes severe or other diseases occur Precipitating causes

A systematic search for these precipitating causes should be made in every patient with the new development or recent intensification of HF. The prognosis in patients with HF in whom a precipitating cause can be identified,treated,and eliminated is more favorable than in patients in whom the underlying disease process has progressed to the point of producing HF without a detectable precipitating cause

A systematic search for these precipitating causes should be made in every patient with the new development or recent intensification of HF. The prognosis in patients with HF in whom a precipitating cause can be identified, treated, and eliminated is more favorable than in patients in whom the underlying disease process has progressed to the point of producing HF without a detectable precipitating cause

4.MECHANISMS OF HEART FAILURE 10

10 4. MECHANISMS OF HEART FAILURE