Via practica 9/2006

PATHOPHYSIOLOGY OF HEART FAILURE

Chronic heart failure is the condition, when the heart is not able to maintain the adequate perfusion of the periphery despite normal left ventricular filling pressure. The heart failure need not be manifested as a congestive state in the first period of the disease, since compensating mechanisms can counterbalance the functional disability of the afflicted ventricle. Later on, however, the compensating mechanisms become insufficient and the heart ceases to supply the periphery with adequate amount of blood. As an answer on the functional deterioration of the myocardium, stress reaction sets in. In such a case, the aim of the subsequent neurohumoral alterations is not to maintain the adequate perfusion of the periphery any more, but just to postpone the failure of the organism per se. The quality of life of the particular individual is substantially decreased. The strengthening of the stress reaction supports the deterioration of the heart function and within a relatively short period the heart ultimately fails.

Keywords: heart failure, compensatory mechanisms, stress reaction.