PATHOPHYSIOLOGY OF HEART FAILURE

Myocardial Dysfunction(Ischemic heart disease)

Dec. cardiac output

Dec. systemic blood pressure
Dec. perfusion to lidneys
activation of baro receptors
Activation of rennin-angiotensin-aldosterone (left ventricle,aortic arch,carotid sinus)
system
Angiotensinogen
Stimulation of vasomotor regulatory centers
Angiotensin I(Lungs) in medulla
Angiotensin II
Inc aldosterone Activation of sympathetic nervous system
(sodium and water retention,arginine
vasopressin,endothelin,cytokines)
Inc. catecholamines(epinephrine and
norephinephrine)->vasoconstriction

Vasoconstriction (inc afterload, increase BP, increase heart rate)

VENTRICULAR REWMODELLING