Chronic heart failure

Overview cardiac dysfunction was defined as different causes of cardiac contractile dysfunction, development of the cardiac output so that the cycle of blood and vasomotor function to normal body metabolism can not meet the needs of blood, thereby leading to the hemodynamic and neurohumoral abnormal activation system features both the clinical syndrome. Interested dysfunction syndrome or heart failure syndrome known. Pump Failure originally referred to the acute myocardial infarction left ventricular failure, is the different causes of cardiac pump function dysfunction, Some EC called pump failure, the traditional concept that heart failure patients had symptoms of bleeding organ, which is also known as congestive heart failure. New concept that cardiac dysfunction can be divided into asymptomatic and symptomatic phase two, former ventricular dysfunction objective evidence (such as left ventricular ejection fraction decreased heart), without the typical congestive heart failure symptoms and heart function is the NYHA (New York Heart Association) Class I, symptoms of heart failure are in the early stage, if not treated effectively, will sooner or later develop into symptomatic cardiac dysfunction. According to the cardiac dysfunction occurred priorities, circulatory decompensation degree of difference, there are clinical acute cardiac insufficiency, Chronic heart failure and decompensated heart failure, such as different manifestations. In recent years ventricular diastolic function of technological development, it possible to distinguish between ventricular systolic dysfunction and mainly ventricular diastolic dysfunction mainly caused by heart failure, which will be divided into cardiac dysfunction systolic ventricular dysfunction and diastolic cardiac dysfunction. Chronic primary ventricular cardiomyopathy and long-term pressure or volume overload. can be caused secondary or primary myocardial dysfunction. In the early days, through compensatory adjustment, either ventricular cardiac output (CO) and the output per minute (cardiac output), meet the rest and metabolic activities of the organization; In the later stages, Even through the full compensatory adjustment has been unable to maintain sufficient stroke volume and cardiac output. The former is called chronic heart failure (chronic Cardiac insufficienc y) in compensation, also known as the potential, compensatory or asymptomatic ventricular dysfunction; The latter is also known as chronic heart failure patients with decompensated, also known as decompensated heart failure. Because of chronic heart failure decompensated Most of the resistance congestive organ (or bleeding) performance, thus often referred to as congestive heart failure, also known as symptomatic heart failure. Etiology of adult patients with congestive heart failure and the most common disease because coronary atherosclerotic heart disease (CHD). Hypertensive heart disease (centrifugal disease), valvular disease, myocardial disease and pulmonary heart disease (cor pulmonale). Other common causes are myocarditis, nephritis and congenital heart disease. Less susceptible to see the neglect is the cause of pericardial disease, hyperthyroidism and receded, anemia, beriberi, arteriovenous fistula, atrial myxoma and other cardiac tumors, connective tissue disease, altitude sickness and rare endocrine disease. Above the basic reason for the failure, through the mechanism affect cardiac function, cause heart failure. (1) Primary impaired myocardial contractility, including myocardial infarction, myocarditis, degeneration or necrosis (such as rheumatic or viral myocarditis, diphtheria myocardial necrosis), myocardial fibrosis or hypoxia (such as coronary heart disease and pulmonary heart disease, cardiac disease), myocardial metabolism, toxicity, Du myocardial contractility and lead to weakened heart failure. (2) ventricular pressure load (after loading) overweight pulmonary and systemic hypertension, left and right ventricular outflow tract obstruction. aorta or pulmonary stenosis, and so on can ventricular contraction resistance increased after heavier load, caused secondary weakened myocardial function and lead to heart failure. (3) the ventricular volume load (before load) excessive valve insufficiency, cardiac or vascular between left to right shunt. ventricular diastolic volume increase, the former heavier load, but also can cause secondary diminished myocardial contractility and heart failure. (4) high power circle mainly occurred in the state of anemia, systemic arteriovenous fistula, hyperthyroidism, beriberi heart disease, peripheral vascular resistance due to decreased cardiac output increased, and can also cause ventricular volume load increase, lead to heart failure. (5) insufficient ventricular preload mitral stenosis, cardiac tamponade and restrictive cardiomyopathy, ventricular filling limited, physical, Congestive pulmonary circulation. Heart failure induced by domestic factors analysis of clinical data, 89.8% of heart failure induced seizures are factors. Common incentives are as follows : 1. Infection of respiratory tract infection for the most, followed by rheumatic fever. Children accounted for rheumatic fever in the first. Female patients with urinary tract infections are also common. Subacute infectious uveitis often heart by heart valves and myocardial damage induced heart failure. 2. Excessive physical activity and emotional excitement. 3. Excessive sodium intake. 4. Arrhythmia particularly rapid arrhythmia, if accompanied by the rapid ventricular rate of atrial fibrillation (AF). Atrial flutter (atrial flutter). 5. Pregnancy and childbirth. 6. Infusion (especially with the liquid sodium), blood transfusion and excessive (or) too much. 7. Digitalis excessive or deficient. 8. ① drugs inhibit the use of myocardial contractility in drugs such as beta-blockers, catecholamines in vivo drug consumption (reserpine). ganglia blocker (such as acridine guanidine B) and some anti-arrhythmic drugs (eg, quinidine, procainamide for amines, Verapamil, etc.); ② sodium and water retention, hormone and drug use, such as the adrenal hormones cause sodium and water retention. 9. Other bleeding and anemia, pulmonary embolism, ventricular aneurysm expansion, uncoordinated myocardial contraction, the papillary muscle dysfunction.