病理生理英文课件1

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1、HeartFailure心力衰竭1LearningObjectivesLearningObjectives•review•definition•etiology•classification•mainmechanisms•bodyresponsetoheartfailure•clinicalmanifestations•treatingprinciples2IntroductionIntroduction3IntroductionIntroductionPerfectconductivesystemHeartrateRhythmCoordinati

2、onValve,atrium,ventricle4IntroductionIntroductionTurkeyredDarkredinterventricularseptumIntactcompartmentinteratrialeseptum5IntroductionIntroductionDeterminantsofcardiacfunctionDeterminantsofcardiacfunctioncontractilitypreloadafterloadRememberthis?CanpatientwithStrokeVolumecard

3、iacshockHeartratemaintaintheirBPinshockstage1?Cardiacoutput6=SV×HRDefinitionDefinitionHeartfailureistheinabilityofthehearttosupplyadequatebloodflowandgenerateacardiacoutputsufficienttomeetthemetabolicdemandsofthebody.7PrevalencePrevalence1996WHOsurvey:Incidencerate1.9%men>wome

4、n2-yearmortalityrate37%6-yearmortalityrate82%American:2to3million400,000newcasesChina:cerebralvasculardiseases,tumor,heartdisorderWHOprediction:cardiacandcerebralvasculardiseasesshouldbetheNo.1killerin20208EtiologyEtiologyPrimarymyocardialdirectimpairmentofmyocardialdysfunctio

5、ncontractilityanddiastolicfunctionischemicheartdisease(infarction,shock…)myocarditis,cardiomyopathy,Kawasakidisease,Ventricularresultinexcesspressure,overloadvolumeorhigh-outputstateshypertension,aorticstenosis,pulmonaryembolism,pulmonaryheartdiseaseafterload↑aorticormitralre

6、gurgitationpreload↑hyperthyroidism,anemia,pregnancyorinfectionRestrictionofMitral/tricuspidstenosis,fillingconstrictivepericarditis9EtiologyPreload&afterloadchange:lefttorightshuntcongenitalheartdiseaseatrialseptaldefect(ASD,房缺)ventricularseptaldefect(VSD，室缺)A-Pfistula(patent

7、ductusarteriosus,PDA）（动脉导管未闭)10EtiologyVenousadmixturehypoxemiaASD:atrialseptaldefectChangeofhemodynamics:late,righttoleftshunt11EtiologyUremia,lungcancer,rheumaticmyocarditis（hemolyticstreptococcus）ConicalBeaker-likePericardialeffusion12influencingfactorsPredisposingPredispos

8、ingfactorsfactors△SystemicInfection:fever,BMR,sympatheticN,cy