Congestive Heart Failure with systolic and diastolic dysfunction of the heart. Features of right and left heart failure is also added.

1. Congestive Heart Failure
Prepared by: Anish Dhakal (Aryan)
anishdhakal718@gmail.com
MBBS Student
Patan Academy of Health Sciences

2. Objectives
• To clarify the congestive heart failure
along with its causes

3. Congestive Heart Failure
• pathophysiologic state
impaired cardiac function
is unable to maintain
an adequate circulation
for the metabolic needs
of the tissues of the body

4. Congestive Heart Failure
• Systolic dysfunction
(Intrinsic Pump failure)
• Diastolic dysfunction
(Impaired filling)
• Increased Workload on Heart

5. Systolic dysfunction
• Pumping is possible only at higher than
normal end-diastolic pressure
• Forward failure & Backward failure
• Also can be caused by:
High oxygen demand
Poor oxygen carrying capacity

6. Systolic dysfunction
• Ischemic Heart Disease
• Systemic Hypertension
• Valve dysfunction (stenosis)
• Myocardium diseases (myocarditis ,
cardiomyopathies)
• Disorder of the rhythm (atrial
fibrillation and flutter)

7. Diastolic dysfunction
• Cardiac
tamponade(Haemopericardium,
Hydropericardium)
• Constrictive pericarditis

9. Increased Workload to the Heart
• In pressure overload states:
Increase in wall thickness, chamber size
same
• In volume overload states:
Chambers dilate, wall thickness may be
normal or altered

10. Physiology of Increased Workload
• In healthy heart:
Frank-Starling mechanism cause increased
C.O. overcoming decreased pressure
governed by Laplace law
• In CHF even when blood volume is more &
hypertrophy present ,ejected blood is low
• In addition myocardial oxygen demand
elevates

11. Left & Right Heart Failure
• Left Heart failure caused by:
 Ischemic Heart Disease
Systemic Hypertension
Valve dysfunction (stenosis)
Myocardium diseases (myocarditis ,
cardiomyopathies)
• Right heart failure by LHF and cor
pulmonale