Risk Factors: Genetic

 Hytension for 16 years predisposition

 Men (64 years old)
 Cigarette smoking (32
pack years)
 Alcoholic drinker for 32 cell membrane
years alteration
 Fond of eating fatty foods
 Physical inability
 ↑ sodium intake functional
 Hereditary
\
vasoconstriction

↑ peripheral
resistance

HPN
(↑ BP)

Vasoconstriction of
blood vessels

Vasoconstriction of ↑ afterload
coronary arteries

↑ workload
Increase pressure of of the LV
blood flow

↑ force of LV
contraction
Injury of the endothelial
vessel layer
(coronary artery) Apex beat
↑ stress on the is heard at
left ventricular 6th ICS
wall AAL
Vessel damage
↑ cardiac output
Left ventricular
↑ LV oxygen
Monocytes, platelets,cholesterol Hypertrophy
demand
and other blood components and dilation
come in contact

Ventricular remodeling LV Hypoxia

Scarring
Atherosclerosis
 ↓ left ventricular
contractility
CAD

↑ residual blood of
the LV at the time of
↓ cardiac tissue diastole
blood flow

↑ LV pressure
↓ cardiac muscle
contraction

↓ Cardiac Output blood backflows

{
from LV to LA
Activation of
baroreceptors in the LV,
aortic arch, carotid sinus ↓ Systemic blood ↑ residual blood
pressure of the LA during
diastole
Stimulation of
vasomotor regulatory
↓ Perfusion of
centers in medulla tissues of the body ↑ LA pressure

Activation of ↓GFR ↓ Renal blood returns to

sympathetic Perfusion pulmonary circulation
nervous system
Renin
Accumulation of
↑ catecolamines blood in the
(epinephrine/ formation of pulmonary capillary
norepineohrine) Angiotensin I bed
(Lungs)
ACE
Angiotensin II
Hypothalamus
Sodium and
ADH Water retention
Pulmonary edema:
dyspnea, easy
fatigability, 2 pillow
↓ urine output ↑osmotic orthopnea
pressure
 ↑ Venous Return ↑ pulmonary
vascular resistance

Blood pools back to

RV

↑ Work
Load of RV

↑ RV oxygen Left ventricular ↑ stress on the ↑ force of RV

demand Hypertrophy Right ventricular contraction
and dilation wall

↓ Right ventricular
RV Hypoxia Ventricular remodeling
contractility

↑ residual blood
of the RV at the
time of diastole

↑ RV preload

blood backflows
from RV to RA

↑ RA pressure
Peripheral edema
↑ RA preload

↑ fluid moves into blood backflows

the interstitial space from RA to systemic
circulation