Systolic Heart Failure Answer 2022

Running head: SYSTOLIC HEART FAILURE
SYSTOLIC HEART FAILURE
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SYSTOLIC HEART FAILURE
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Answer number 1.
Acute exacerbation of chronic heart failure is the clinical diagnosis for Mrs Brown. The
pathogenesis of the systolic heart failure is related with the dysfunction of heart which underlie
with disruption in transmission of signal and irregular heart rhythm. Heart failure happens when
there is inadequate pumping of blood which cause low cardiac output. Heart failure in patient is
because of damage of cardiac cells which is related to alcoholic cardiomyopathy and
degenerative valve disease. According to the study of Volpe, Carnovali and Mastromarino
(2016), it can be analyzed that heart failure mainly occur in elderly patient reported with
numerous comorbidities like lung disease, angina, hypertension, diabetes and high cholesterol.
In normal functioning of heart, the blood is transported to the heart through aorta and it is
transmitted to the rest of the body by the pulmonary veins and arteries. Heart failure happen
there is narrowing of arteries and veins due to accumulation of high cholesterol or other
indigestible materials. The blood is not able to be circulated with full efficiency and encounter
resistance in the flow. It lead to inefficient pumping of heart and low cardiac output. It is evident
from the case study of Mrs Brown that she was having issue with breathing, had dyspnea, high
blood pressure and low level of oxygen saturation. The sign and symptoms were relevant with
the heart failure. Hart failure cause difficulty in breathing because as the blood is not able to flow
with adequacy, oxygen is not reached to every cell and in lung which leads to dyspnea. However,
according to Asgar, Mack and Stone (2015) systolic heart failure is also connected to the
systematic response.
Concerning to pathophysiology, tow important term is needed to be considered. First,
preload which is the amount of blood entering into right ventricle chamber and afterload amount

SYSTOLIC HEART FAILURE
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of blood which expelled from the left ventricle. Initiation of compensatory mechanism, leads to
high cardiac output. The two crucial mechanism are sympathetic nervous system and renin-
angiotensin aldosterone system. The two system gets stimulated when there is drop in blood
pressure. It causes activation of carotid baroreceptor of sympathetic nervous system which
causes elevation of the epinephrine and norepinephrine. These two hormones are the major
reason for the high contraction of the heart muscle, high afterload and high heart rate which also
leads to the peripheral constriction. The impact of it is deleterious as it causes decline of systole
of left ventricles and result in systolic heart failure. According to the law of Frank starling, due to
high contraction of ventricle, large amount of blood is filled in the heart. In case of heart failure,
there is low amount of blood entering into the heart and coming out of the heart due to less
contraction of the heart muscle. It is evident from the study of Harjola et al. (2017) that
contraction of heart muscle is low because of inefficient action of myosin and actin filament. As
the systole fails, the stroke volume gets declines.
Looking into the renin-angiotensin-aldosterone system, in account of high blood pressure,
there is low perfusion of blood and kidney undertake hypovolemia. As the result of it, there is
high level of sodium and water which simulates renin-angiotensin-aldosterone system. In
situation of vasoconstriction, the level of angiotensin which lead to high flow of blood and
causes adverse remodelling of the heart (Ter Maaten et al., 2015).
It is reported from the study of Stembridge et al. (2015) that systolic dysfunction implies
low stroke volume and incomplete emptying of the blood from the heart. The major reason being
the loss of the function of myocytes due to necrosis, loss of contractile protein, apoptosis and
essential ions. It also causes lack of transmission of the electrical impulse by disrupting the
function of SA node. The above discussion contribute to the systolic heart failure.