Need simple pathophyisology flow chart of Cardiac Heart Failure?

Question

Struggling with a simple chart with a few words then arrows to show what happens in CHF

Answer 1

1) Initial insult - or combination of insults - to the myocardium resulting in decreased cardiac output.

Heart failure will induce changes in the physiologic response to decreased cardiac output - examples of initial insults are: arrhythmia/tachycardia, infarct, valvular dysfunction, hypertension, ischemia, and non-ischemic cardiomyopathy.

The exact response will vary depending on the primary insult and course of onset (i.e. acute or chronic). These compensatory mechanisms may be appropriate and beneficial in the short term but can act to exacerbate and perpetuate the disease process over the long term in chronic heart failure.

2) Cardiac Responses to Myocardial Stress

Excess volume produces dilation of the ventricles whereas excess pressure produces ventricular hypertrophy. These processes are meant to accommodate blood flow through the heart. However, over the long term hypertrophy can lead to increased oxygen consumption and diastolic dysfunction (inability to wholly relax thereby reducing filling) while dilation can result in poor contractility (systolic failure).


3) Neurohormonal Responses to Low Circulating Volume

The sympathetic nervous system and renin-angiotensin system are the major responses involved. Together, they will act to cause systemic vasoconstriction, tachycardia, increased myocardial contractility and renal salt and water retention in an attempt to maintain blood pressure and thus adequate tissue perfusion. Chronically, systemic vasoconstriction will decrease cardiac output by increasing systemic vascular resistance (elevate blood pressure). Increased heart rate and myocardial contractility will simply increase oxygen consumption (often exacerbating ischemia already there). Salt and water retention will cause venous congestion (pedal edema).


4) Repeating of the cycle

This whole process can be a repeating cycle of the responses causing decreased cardiac output (and therefore more cardiac injury) causing more responses.

In view of the detrimental results of these compensatory processes, many treatments are designed to depress them until the primary insult can be dealt with - arrhythmia corrected, ischemia improved, valve repaired, hypertension treated, etc.

Good luck.

Answer 2

1

Answer 3

2