Heart Failure – Systolic dysfunction and Diastolic dysfunction

Systolic Dysfunction

It is easy to recognize the Heart failure caused by systolic dysfunction and in simple words it can be mentioned as the inability of the heart to pump blood to the different parts of the body. This systolic dysfunction is characterized by a reduced ejection fraction that is less than 45%. The strength of ventricular contraction is reduced leading to inadequate cardiac output. This is caused by the dysfunction cardiac myocytes. Inflammation and infiltration can lead to the destruction of Myocytes and its components. The presence of Toxins and pharmacological agents also result in intracellular damage and oxidative stress. The ischemia results in infarction and scar formation. Once the myocardial infarction occurs, the dead myocytes got replaced by scar tissue, and affects the functioning of the myocardium. This can be manifested in ECG in form of abnormal or absent wall motion.

Diastolic dysfunction

The diastolic dysfunction  of the Heart failure is termed as the failure of the ventricle  to relax adequately and result in a stiff ventricular wall. This results in inadequate filling of the ventricle leading to inadequate stroke volume. This failure of ventricular relaxation causes elevated end-diastolic pressures, where the effects are similar to the systolic dysfunction including pulmonary oedema in left heart failure and peripheral oedema in right heart failure. Diastolic dysfunction is caused by those processes that results in systolic dysfunction and includes the causes that leads to changes in cardiac remodelling. Diastolic dysfunction manifest itself only in physiologic extremes the systolic function is maintained. The patient does not show any symptoms at rest and they become sensitive to increases in heart rate, and sudden bouts of tachycardia. The pharmacological agents like such as a calcium channel blocker or a beta-blocker, are used for adequate rate control that can slows down the AV conduction.

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