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PATHOPHYSIOLOGY OF CONGESTIVE HEART FAILURE

Predisposing Factors Precipitating/Aggravating Factors


Age, Gender, Family Disease Process: Coronary Artery Disease,
History Myocardial Infarction, Valvular Disease,
Hpertension, Dysthrymia
Obesity, Sedentary lifestyle, Salt and Fats Diet

Stimulation of Renin-Angiotensin Initial Event that pumping


System capacity

Angiotensi Stimulation of arterial


n chemoreceptors,baroreceptors and
cardiopulmonary baroreceptors
AD Aldosteron Stimulation of Adrenergic
H System,esp.

Sodium and Water


Retention Peripheral and
Peripheral Heart Rate Vascular
Weight and resistance
pulmonary
gain edema
Myocardial
Oxgen Use
Renal Afterload
Cardiac Blood Flow
Preload B
P
Ventricular
Remodeling Cool, pale
extremities
Progressive loss of cardiac
output

Stimulation of Cytokine
System

Myocardial
Hypertrophy

Loss of
Myocytes
CONGESTIVE HEART

Left-sided Heart Right-sided Heart


Failure Failure
Ineffective left ventricular
Ineffective right ventricular
contractility

Failure of the left ventricular Failure of the right ventricular

Decrease cardiac output to the Decreased cardiac output to

Blood back into left atrium and Blood back into right atrium and peripheral

Pulmonary congestion, dyspnea, activity Weight gain, peripheral edema,


engorgement of kidney and other
organ
Pulmonary edema and right-sided heart

Bibliography/Source: Block, Joyce M. et al. Cardiac Disorders. Medical-


Surgical Nursing.
Volume 2. 8th edition, 2009,p.1433