1、Congestive heart failure,Ivan Ceroveki Mentor: A. mega Horvat,Elementary notions,Cardiac outputPeripheral circulationPreloadAfterload,Definition of CHF,Complex syndromeImpaired function of the heartCompromised peripheral perfusion,Epidemiology,Prevalence in Europe: 2 %Prevalence 65 yrs: 10 %1st year
2、 mortality: 30 40 %5 year mortality: 60 70 %,Clinical characteristics,Acute heart failureChronic heart failure,Clinical characteristics,Left heart failureRight heart failureBiventricular (congestive) heart failure,Aetiology,Cardiac pathologyIschaemic heart diseaseHypertensive heart diseaseCardiomyop
3、athyValvular heart diseaseCongenital heart diseasePericardial disease,Aetiology,Extracardiac pathologyPulmonary disease: pulmonary embolismEndocrine and metabolic diseaseInfective diseaseToxic substances: alcohol,Pathophysiology,Sympathetic activationIncreased heart rateIncreased myocardial contract
4、ilityVenous vasoconstrictionArteriolar vasoconstriction,Pathophysiology,RAAS systemArteriolar vasoconstrictionFluid retention,Pathophysiology,Natriuretic peptidesDiuretic effectNatriuretic effectHypotensive effect,Pathophysiology,Ventricular dilatationIncrease in metabolic requirements,Clinical feat
5、ures,Common symptomsFatigueDyspnoeaPalpitationsWeight gain,Clinical features,Left heart failureParoxysmal nocturnal dyspnoeaOrthopnoeaBasal lung cracklesPresence of the third heart sound,Clinical features,Right heart failureJugular venous distensionHepatomegalyPeripheral oedema,Diagnostics,Chest X-r
6、ayECGBlood testsEchocardiographyNatriuretic peptide,Treatment,Vasodilator therapyACE inhibitorsAngiotensin II receptor antagonistsNitratesHydralazine,Treatment, blockersMetoprololBisoprololCarvedilol,Treatment,DiureticsLoop diureticsThiazide diureticsPotassiumsparing diuretics,Treatment,DigoxinDopam
7、ineDobutamineAntiarrhythmic drugs,Treatment,RevascularizationBiventricular pacemakerCardiac transplantation,References,Vrhovac B et al: Interna medicina, Naklada Ljevak, 2008 Ballinger A, Patchett S: Pocket Essentials of Clinical Medicine, Elsevier Saunders, 2007 United States National Library of Medicine (nlm.nih.gov) Wikipedia (wikipedia.org),The end,
