Precipitating factors infection arrhythmias Pulmonary embolism overfatigue Pregnancy and delivery Anemia and hemorrhage others
6 Precipitating factors • infection • arrhythmias • Pulmonary embolism • overfatigue • Pregnancy and delivery • Anemia and hemorrhage • others
Pathophysiology Frank-Starling mechanism Activation of neurohormonal pathway(sas and ras Myocardial damage and remodeling Diastolic heart failure
7 Pathophysiology • Frank-Starling mechanism • Activation of neurohormonal pathway (SAS and RAS) • Myocardial damage and remodeling • Diasatolic heart failure
LV Remodeling Post MI Acute infarction (hours) Infarct expansion (hours to days Global remodeling (days to months)
8
CLINICAL CLASSIFICATION a cute vs. chronic heart failure Right-sided vs left-sided Heart failure Low-output vs high-output heart failure Systolic vs diastolic heart failure Asymptomatic vs congestive heart failure
9 CLINICAL CLASSIFICATION • A cute vs. chronic heart failure • Right-sided vs. left-sided Heart failure • Low-output vs high-output heart failure • Systolic vs diastolic heart failure • Asymptomatic vs congestive heart failure
Chronic left-sided hf: symptoms Respiratory distress ■ Exertional dyspnea Paroxysmal nocturnal dyspnea Orthopnea Acute pumonary edema Cough(nonproductive), and hemoptysis Reduced exercise capacity Fatigue and weakness Urinary symptoms
10 Chronic left-sided HF ：symptoms Respiratory distress Exertional dyspnea Paroxysmal nocturnal dyspnea Orthopnea Acute pumnonary edema Cough (nonproductive), and hemoptysis Reduced exercise capacity Fatigue and weakness Urinary symptoms