Causes of heart failure

In the age aspect, the etiological factors of heart failure may be the following:

• the period of the newborn: congenital heart defects, as a rule, at this age complex, combined and combined;
• Infant age:
  • Congenital heart defects, congenital myocarditis - early (fibroelastosis of the endocardium and myocardium) and late;
  • acquired valvular heart disease, at this age - as a consequence of infective endocarditis;
  • acute myocarditis.

Congenital heart defects are probably the most common cause of heart failure at any age. However, at a certain age, other causes of heart failure are also revealed. So, from the age of 7 (very rarely earlier), the formation of valvular heart defects of rheumatic genesis, as well as the formation of rheumatic heart disease with a predominant myocardial lesion, is much less common - the formation of rheumatic pancarditis.

Cardiomyopties - dilated (stagnant) and hypertrophic - manifest clinically, manifestly at any age.

Infrequent causes of heart failure are conditions defined as arrhythmogenic heart failure due to overuse of the myocardium, for example in some forms of chronic tachyarrhythmias.

Extracardial causes of heart failure - kidney disease with the phenomena of oliguria and anuria, bronchopulmonary pathology - a syndrome of hyaline membranes in newborns, acute and chronic pneumonia, fibrosing alveolitis (Hammain-Rich syndrome), trauma. Unfortunately, clinical situations of iatrogenic heart failure are encountered, most often with inadequate administration of infusion therapy. In clinical practice, we had to deal with situations where infusion therapy was prescribed already in cases of heart failure, in particular against the background of the current acute myocarditis, "for the purpose of detoxification." Undoubtedly, such therapeutic tactics leads at best to an increase in the severity of the patient's condition.

With some extracardiac conditions (hyperthyroidism, severe forms of anemia, cirrhosis of the liver, arteriovenous fistula), an increase in cardiac output is noted, and the circulatory disturbance is due to the fact that the pumping function of the heart is not able to meet the increased needs of the body.

Given the etiological factors leading to damage to the heart muscle, we can identify the following forms of heart failure.

• Myocardial-exchange form, or heart failure from damage, occurs with diseases of the heart muscle of a toxic, infectious and allergic nature, i.e. This form is caused by a primary damage to the heart muscle without previous hypertrophy.
• Heart failure from overload is a condition in which the contractility of the myocardium decreases as a result of fatigue and secondary changes based on hyperfunction. Such changes are most often accompanied by heart defects, as well as states of increased pressure in the small and large circles of the circulation.
• Mixed form of heart failure, which combines factors of damage and heart overload, for example, in thyrotoxicosis and rheumatic heart diseases.

There are still systolic and diastolic forms of heart failure.

• With a systolic form, a decrease in cardiac output is due to a decrease in myocardial contractility or volume overload.
• The diastolic form is caused by a decrease in the filling of the heart cavities (ventricles) in the diastole, most often this situation occurs when the myocardium relaxes in the diastole phase, which is possible with hypertrophic, obstructive cardiomyopathy, constrictive pericarditis, a decrease in the volume of cavities due to tumors, or with tachysystolic forms of rhythm disturbance, when there is a shortening of the diastole.

[1], [2], [3], [4], [5], [6], [7], [8]