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Pathophysiology of Heart Failure

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Increased Afterload

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An increase in the resistance that the heart must pump against, which can lead to or exacerbate heart failure.

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Arrhythmias

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Irregular heartbeats can arise from heart failure, leading to a further decrease in cardiac efficiency and output.

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Peripheral Edema

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Fluid accumulation in the body tissues, often in the lower extremities, due to right-sided heart failure and venous congestion.

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Neurohormonal Activation

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Activation of systems like the renin-angiotensin-aldosterone system (RAAS) can lead to fluid retention, vasoconstriction, and further cardiac dysfunction.

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Exercise Intolerance

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Inability to perform physical activity due to reduced cardiac output, poor oxygenation, and fatigue associated with heart failure.

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Diastolic Dysfunction

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The heart's ability to relax and fill during diastole is impaired, causing increased filling pressures and symptoms of congestion.

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Decreased Contractility

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A reduction in the force with which the heart muscle contracts, diminishing cardiac output and tissue perfusion.

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Ventricular Remodeling

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Alterations in the size, shape, and function of the heart after injury, leading to further decline in cardiac function.

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Systolic Dysfunction

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The heart's ability to contract is impaired, leading to a decrease in ejection fraction and cardiac output.

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Renal Insufficiency

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The kidneys' function deteriorates due to diminished blood flow, which can trigger fluid retention and further worsen heart failure.

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Increased Preload

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Elevated venous pressure leads to increased ventricular filling and myocardial stretch, potentially worsening heart failure.

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Cachexia

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Severe weight loss and muscle wasting seen in advanced heart failure due to chronic inflammation and malnutrition.

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Functional Mitral Regurgitation

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Leakage of the mitral valve not due to valve defects but secondary to ventricular dilation and dysfunction in heart failure.

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Pulmonary Edema

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Fluid accumulation in the lungs due to elevated left ventricular filling pressures, resulting in shortness of breath and hypoxia.

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Cyanosis

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A bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood resulting from heart failure.

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Endothelial Dysfunction

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Impaired function of the blood vessel lining, leading to altered vasomotion and contribution to increased afterload.

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Reduced Cardiac Output

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Occurs when the heart can't pump enough blood to meet the body's needs, leading to fatigue and shortness of breath.

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Myocardial Hypertrophy

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The heart muscle thickens in response to increased workload, which can eventually lead to a stiff and less efficient heart.

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