Heart Failure

Heart failure (cardiac failure) is not a disease but a syndrome, with many possible aetiologies and a complex pathogenesis, yet it may be simply defined as the failure of the heart to meet the normal perfusion demands of the body.

The causes of heart failure may be considered in two broad groups:

1. Pump failure, with primary reduction in myocardial contractility.

2. Overloading, with either excessive afterload (pressure overload) or excessive preload (volume overload), which arise outside the heart and reduce contractility secondarily.

Specific causes within these groups may give rise to failure acutely or chronically and may initially affect one specific chamber or side of the heart. However, in chronic heart failure both sides are usually affected eventually.

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