Pathophysiology of Chf Essay

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PHARMACOMECHANICAL APPROACH TO CHF TREATMENT Pathophysiology of Congestive Heart Failure Gary S. Francis, MD,* † W.H. Wilson Tang, MD† *George M. and Linda H. Kaufman Center for Heart Failure, †Department of Cardiology, Cleveland Clinic Foundation, Cleveland, OH Heart failure is a clinical syndrome characterized by impaired structure and/or function of the heart, leading to dyspnea and fatigue at rest or with exertion. The pathophysiology of heart failure is complex, and there is no single lesion. Any form of heart disease can lead to heart failure. Most heart failure can be explained by well-recognized etiologic factors, though ostensibly healthy patients may harbor risk factors for the later development of heart failure. A fundamental response to myocardial injury or altered loading conditions includes “remodeling” of the heart, so that the size, shape, and function of the affected chamber is grossly distorted. This is accompanied by a constellation of biologic changes, best recognized in advanced cases of heart failure. These multiple alterations may be primary or secondary events but, nonetheless, add importantly to the morbidity and mortality of the patients. More emphasis should be placed on recognition and correction of risk factors related to the development of heart failure. [Rev Cardiovasc Med. 2003;4(suppl 2):S14–S20] © 2003 MedReviews, LLC Key words: Heart failure • Dilated cardiomyopathy • Systolic dysfunction • Cardiac myocyte hypertrophy T S14 VOL. 4 SUPPL. 2 2003 here are few clinical syndromes that have undergone both the conceptual and epidemiologic transformation that has occurred with heart failure. The entire concept of what the heart failure syndrome is, how it begins, how it naturally unfolds, and how its primary phenotypic expression is manifested has undergone radical change since the 1970s. This has occurred simultaneously

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