Outline the typical pathophysiology of heart failure. Onset of heart failure usually can be traced to damage from an MI and atherosclerosis. Is this consistent with Mrs. Maney's history?

Question

What will be an ideal response?

Answer 1

• Many different events can lead to the development of congestive heart failure.
• Previous myocardial infarction, valve defect, or increased work demand on the heart from other conditions such as hypertension all can damage the heart.
• This damage results in a decreased ability of the heart to pump adequately.
• When there is reduced blood flow to tissues, the body compensates in several ways.
• The kidney responds to decreased blood flow by secreting renin and aldosterone, causing vasoconstriction and an increase in blood volume.
• The heart then has to work even harder to handle the increased blood volume.
• Over time, the heart enlarges (cardiomegaly) with its attempt to handle the increased workload.
• Cardiac output and stroke volume decrease.
• Compensation mechanisms do work for a time but eventually the heart muscle weakens.
• Dr. Maney's medical history is consistent with the typical pathophysiology of heart failure. She has a long history of coronary artery disease, hypertension, and mitral valve disorder. She also experienced a myocardial infarction. Her previous medical diagnoses are all indicative of damage to the heart muscle, which is the first step in the progression of heart failure.