中国医科大学附属第一医院：《内科学》课程教学资源（PPT课件讲稿，双语版）Heart Failure

Heart Failure 7 years program of China Medical University Xiaojuan Bai

Heart Failure Xiaojuan Bai 7 years program of China Medical University

Obiective 1. Mastering clinical manifestation diagnosis and management of heart failure 2. Grasping causes, pathophysiology of heart failure 3. Understanding classification and investigation of heart failure

Objective : 1.Mastering clinical manifestation ,diagnosis and management of heart failure 2.Grasping causes,pathophysiology of heart failure 3.Understanding classification and investigation of heart failure

Content I general concept 1)causes of heart failure 2)precipitating/aggravating factors 3)pathophysiology 4)type of heart failure 2. chronic and acute heart failure 1)clinical manifestation 2)investigation 3)diagnosis and differential diagnosis Management

1.general concept 1)causes of heart failure 2)precipitating/aggravating factors 3)pathophysiology 4)type of heart failure 2.chronic and acute heart failure 1)clinical manifestation 2)investigation 3)diagnosis and differential diagnosis 4)management Content

Aortic dissection A orta .t Pulmonary embolism Arrhythmia Mitral valve disease RA Aortic valve disease Right ventricular Left ventricular damage infarct Myocardial infarction RV Myocarditis Pericardial tamponade

Definition Heart failure is an imprecise term used to describe the state that develops when the heart cannot maintain an adequate cardiac output or can do so only at the expense of an elevated filling pressure

Heart failure is an imprecise term used to describe the state that develops when the heart cannot maintain an adequate cardiac output or can do so only at the expense of an elevated filling pressure. Definition

Clinical featur pulmonary congestion systemic venous congestion, tissue perfusion deficiency due to low cardiac output

• pulmonary congestion, • systemic venous congestion , • tissue perfusion deficiency due to low cardiac output . Clinical Features

emodynamic Featu o left ventricular end-diastolic pressure>18mmHg B right ventricular end-diastolic pressure>10mmHg, heart failure= cardiac insuffiency

❖left ventricular end-diastolic pressure>18mmHg, ❖right ventricular end-diastolic pressure>10mmHg, heart failure = cardiac insuffiency. Hemodynamic Features

Causes of heart failure Reduced ventricular contractility a. Cardiomyopathy, myocardial infarction. b. Meta bolic dysfunction

Causes of heart failure 1.Reduced ventricular contractility a. Cardiomyopathy, myocardial infarction. b. Metabolic dysfunction

2. ventricular overload a pressure overload---- hypertension aortic stenosis, pulmonary hypertension, pulmonary valve stenosis b volume overload --- mitral regurgitation, aortic regurgitation, atrial septal defect, ventricular sepals defect, hyperthyroidism, artery-venous fistula c ventricular inflow obstruction----hypertrophy mitral stenosis, tricuspid stenosis, restrictive cardiomyopathy, constrictive pericarditis endocardial fibrosis and other disorders that cause a stiff myocardium

2.ventricular overload a. pressure overload---- hypertension , aortic stenosis, pulmonary hypertension, pulmonary valve stenosis. b. volume overload ---- mitral regurgitation, aortic regurgitation , atrial septal defect, ventricular sepals defect , hyperthyroidism, artery-venous fistula. c. ventricular inflow obstruction----hypertrophy , mitral stenosis, tricuspid stenosis, restrictive cardiomyopathy, constrictive pericarditis .endocardial fibrosis and other disorders that cause a stiff myocardium

Precipitating /aggravating factors myocardial ischemia or intarction infection arrhythmia pulmonary embolism exertion pregnancy and parturition anema intravenous fluid overload, electrolyte disturbance acid-base imbalance

Precipitating / aggravating factors • myocardial ischemia or infarction • infection • arrhythmia • pulmonary embolism • exertion • pregnancy and parturition • anemia • intravenous fluid overload, electrolyte disturbance, acid-base imbalance