PATHOPHYSIOLOGY OF HEART FAILURE

Myocardial Dysfunction(Ischemic heart disease)

Dec. cardiac output Dec. systemic blood pressure Dec. perfusion to lidneys activation of baro receptors (left ventricle,aortic arch,carotid sinus)

Activation of rennin-angiotensinaldosterone system Angiotensinogen Angiotensin I(Lungs) Angiotensin II Inc aldosterone (sodium and water retention,arginine vasopressin,endothelin,cytokines)

Stimulation of vasomotor regulatory centers in medulla

Activation of sympathetic nervous system

Inc. catecholamines(epinephrine and norephinephrine)>vasoconstriction

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

VENTRICULAR REWMODELLING