(2/3) Patofisiologi Gagal Jantung (Left VS Right HF) : # HEART FAILURE

Summary

This video provides an in-depth explanation of heart failure, focusing on its types—systolic and diastolic failure—and their underlying causes, such as ischemic heart disease, hypertension, and cardiomyopathy. It explores the renin-angiotensin-aldosterone system’s role in compensating for reduced blood flow, leading to fluid retention and potential complications like pulmonary edema. The video also covers the stages of edema, from early redistribution of pulmonary vessels to severe alveolar edema. Additionally, it touches on right-sided heart failure, particularly in the context of lung diseases, highlighting symptoms like peripheral edema, jugular vein distention, and organ enlargement.

Takeaways

• 😀 Systolic heart failure occurs when the heart’s pumping function is impaired, often caused by ischemic heart disease, hypertension, or dilated cardiomyopathy.
• 😀 Diastolic heart failure results from the heart’s inability to fill properly during the diastolic phase, commonly due to hypertension or restrictive cardiomyopathy.
• 😀 The Renin-Angiotensin-Aldosterone System (RAAS) is activated when blood supply to the body decreases, leading to sodium and water retention in an attempt to restore blood volume.
• 😀 Left-sided heart failure can cause pulmonary edema, as the backup of blood in the left atrium increases pressure in the lungs and leads to fluid accumulation.
• 😀 Right-sided heart failure often follows left-sided heart failure, with fluid buildup in peripheral veins, causing edema in the legs and abdomen.
• 😀 Acute heart failure is a rapid, often life-threatening condition, caused by sudden events like a heart attack or arrhythmia, and requires immediate intervention.
• 😀 Chronic heart failure develops progressively, with symptoms worsening over time due to ongoing damage to the heart muscle.
• 😀 Pulmonary edema caused by left-sided heart failure can be classified into three stages, ranging from increased vascular markings to alveolar edema.
• 😀 In right-sided heart failure, pressure increases in the pulmonary artery, putting strain on the right ventricle, leading to peripheral edema and other systemic effects.
• 😀 Elevation in jugular venous pressure (JVP) is a common sign of right-sided heart failure, often measured by examining the distance between the jugular vein and the sternum at a 45° angle.

Q & A

What is the primary focus of the video?

The video primarily focuses on explaining heart failure, its types, causes, mechanisms, and its impact on the circulatory system, particularly the left and right ventricles, as well as the associated complications like pulmonary edema and peripheral edema.

What are the two main types of heart failure mentioned in the script?

The two main types of heart failure mentioned are systolic heart failure (due to impaired pumping function) and diastolic heart failure (due to impaired ventricular filling).

How does systolic heart failure occur?

Systolic heart failure occurs due to conditions such as ischemic heart disease, hypertension, or dilated cardiomyopathy, which damage myocardial cells or alter their structure, affecting the heart's ability to contract and pump blood effectively.

What causes diastolic heart failure?

Diastolic heart failure is caused by conditions like hypertension leading to ventricular hypertrophy, restrictive cardiomyopathy (where myocardial stiffness impairs ventricular expansion), or valve damage that affects the filling of the ventricles.

What role does the renin-angiotensin-aldosterone system (RAAS) play in heart failure?

In heart failure, when blood supply to the body is reduced, the RAAS system is activated. This leads to increased heart rate, sodium and water retention, and vasoconstriction, aiming to restore circulatory volume and blood pressure, but it can worsen fluid retention in chronic heart failure.

What is the consequence of prolonged activation of the RAAS in heart failure?

Prolonged activation of the RAAS in heart failure leads to continuous fluid retention, which can cause fluid accumulation in the lungs (pulmonary edema) or other areas like the liver and extremities, further impairing heart function.

What happens when fluid accumulates in the lungs due to left-sided heart failure?

When fluid accumulates in the lungs due to left-sided heart failure, it causes increased pressure in the left atrium, leading to backward blood flow into the pulmonary veins, which can result in pulmonary edema, characterized by shortness of breath, cough, and crackles on lung auscultation.

How is pulmonary edema differentiated from non-cardiogenic edema?

Pulmonary edema caused by heart failure (cardiogenic) is typically associated with clinical signs like paroxysmal nocturnal dyspnea and orthopnea, as well as characteristic radiologic findings such as redistributive vascularity or interstitial edema. Non-cardiogenic edema, on the other hand, is usually due to primary lung diseases like infections or tumors.

What is cor pulmonale, and how is it related to right-sided heart failure?

Cor pulmonale refers to right-sided heart failure caused by primary lung diseases such as pulmonary infections or tumors. It results from increased pulmonary artery pressure, which makes it harder for the right ventricle to pump blood, leading to right-sided heart failure and subsequent fluid buildup in the body.

What clinical manifestations are seen in right-sided heart failure?

In right-sided heart failure, clinical manifestations include peripheral edema (e.g., swelling in the legs and ankles), increased jugular venous pressure, hepatomegaly, splenomegaly, and ascites due to fluid accumulation in the body.