Pathophysiology of Congestive Heart Failure

Non-Modifiable Risk Factors:

Medical Conditions: Modifiable Risk Factors:

 CVA
 Coronary artery disease Excessive alcohol intake
 Myocardial Infarction Excessive tabacco use
 Heart valve disease Obesity
 Hypertension
 Congenital Heart Disease
 Diabetes
Diabetes medications and other certain

Myocardial Dysfunction

Ineffective right ventricular contractility CO BP Perfusion to kidneys Ineffective left ventricular contractility

Failure of right ventricular pumping ability Failure of left ventricular pumping ability
Activation of renin-angiotensin aldosterone system Activation of baroreceptors

Blood backup into right atrium and and Decreased cardiac output to the body
peripheral circulation Renin
Stimulation of vasomotor
regulatory centers in
Peripheral Congestion Blood back up into left atrium and lungs
Converts Angiotensin I to angiotensin II medulla

Jugular vein Distention Abdominal girth Aldosterone Activation of Sympathetic Pulmonary Congestion
nervous system
Hepatomegaly Ascites (abdominal girth) Sodium and water retention Pulmonary edema
Release of epinephrine and
norepinephrine
Swelling of leg and hands Edema (pitting) Arginine vasopressin  Dyspnea
Endothelin  Weakness
 Crackles
Weight gain
Vasoconstriction  Orthopnea
 Nagging cough (frothy/
blood stinged sputum)
Afterload  Gaining weight
Blood pressure
Heart rate
Pathophysiology of Congestive Heart Failure