【精品】open ppt document - 上海交通大学医学院40.ppt

Heart Failure;Heart failure is the pathophysiological state in which the heart is unable to pump sufficient blood to satisfy the metabolic demands of the body with enough preload.;The Progressive Development of Cardiovascular Disease;For progressive duration;;Chronic heart failure;Causes;Pathophysiology of heart failure;Effects of Neurohormonal Stimulation in Heart Failure;Pathophysiology of Heart Failure: Left Ventricular Remodeling;;Ventricular Remodeling: Compensatory Mechanism; ;Vicious Cycle of Heart Failure;Pathophysiology and Therapeutic Approaches to Heart Failure;Common Symptoms of Heart Failure;Common Physical Findings of Heart Failure;Clinical manifestation;Functional Classification;Class 1---No limitation Ordinary physical activity does not cause undue fatigue,dyspnea,or palpitation Class 2---Slight limitation of physical activity Such patients are comfortable at rest.Ordinary physical activity results in fatigue,palpitation,dyspnea,or angina;Class 3---Marked limitation of physical activity Although patients are comfortable at rest,less than ordinary activity will lead to symptoms. Class 4---Inability to carry on any physical activity Symptoms of congestive failure are present even at rest.With any physical activity,increased discomfort is experienced.;;Complication;Laboratory Finding;;;Diagnosis and differential diagnosis;Differential diagnosis;;Therapy; ; ; ; ; ;Cortex;THIAZIDESMECHANISM OF ACTION;LOOP DIURETICSMECHANISM OF ACTION;K-SPARING DIURETICS MECHANISM OF ACTION;Volume and preload Improve symptoms of congestion No direct effect on CO, but excessive preload reduction may Improves arterial distensibility Neurohormonal activatio Levels of NA, Ang II and ARP Exception: with spironolactone;DIURETICS ADVERSE REACTIONS Thiazide and Loop Diuretics ;DIURETICSADVERSE REACTIONS K-SPARING DIURETICS;Na+;DIGOXIN PHARMACOKINETIC PROPERTIES; ; ; ; ; ; ; ; ; ; ;CARDIAC GLYCOSIDES SYMPATHOMIMETICS Catecholamines ?-adrenergic ag