- •27. Pathophysiology of heart.
- •27.1. What is insufficiency of circulation of the blood?
- •27.2 What is result of the insufficiency of circulation of the blood for organs, tissues and organism in whole?
- •27.3 What is cardiac insufficiency?
- •27.4 What is the classification of cardiac insufficiency?
- •27.5 Give short characteristic of different pathogenic variants of cardiac insufficiency.
- •27.6. What types of heart’s overloading can cause the development of cardiac insufficiency?
- •27.7. What mechanisms can provide the compensation of heart during the effect of the increased leading on it?
- •27.8. What is the essence of the heterometric mechanism of the compensation of the heart?
- •27.9. What is the essence of the homeometric mechanism of the compensation of the heart?
- •27.10. What is the essence of the chronoinotropic mechanism of the compensation of the heart?
- •27.11. What is the roll of catecholamines in the realization of mechanisms of urgent compensation of the heart?
- •27.12. Name the variants of prolonged adaptation of the heart to the effect of ladings.
- •27.13. What mechanism lay on the base of development of the heart’s hypertrophy?
- •Hypertrophy
- •27.14. What phases can be distinguished in the process of development of compensatory hypertrophy of the heart? Give their characteristics.
- •27.14 What strategy allocate during development compensatory hypertrophies of heart? Give their characteristic.
- •27.15 What features of the hypertrophied heart are the precondition of its development of decompensation?
- •27.16. What can cause the development of the myocardial insufficiency of heart?
- •27.17. What is hearts arhythmy? How does they classified?
- •27.18. What arhythmias of heart can be a result of infringement of function of automatism?
- •27.19 What reasons and mechanisms of development of a sinus tachycardia and bradycardia?
27. Pathophysiology of heart.
27.1. What is insufficiency of circulation of the blood?
What it can the insufficiency of circulation of the blood is the condition when cardio-vessel system can not supply organs and tissues of organism with necessary of blood. It is the most frequent display of different breaches of functions of blood system. The insufficiency of circulation of the blood can be causes by: 1) cardiac insufficiency; 2) blood vessels insufficiency; 3) cardio-vessel insufficiency (simultaneous insufficiency of heart and vessels.
27.2 What is result of the insufficiency of circulation of the blood for organs, tissues and organism in whole?
1. The breaches of trophic supplying of organs and tissues. They develop as a result of: a) reduction of oxygen’s supply (circulatory hypoxia see # 19), b) reduction of nutritious substances delivery.
2. The breaches of removal from organs and tissues final products of metabolism the result of it is the development of: a) non-gas acidosis; b) intoxication.
27.3 What is cardiac insufficiency?
Cardiac insufficiency – is the pathological condition which is caused by inability of heart to supply blood support of organs and tissues in conformity which their needs.
It is the condition when leading on heart exceeds its ability to provide its function. It displays by the inability of heart to transfer into arterial stream all the blood which comes to it by veins.
27.4 What is the classification of cardiac insufficiency?
I. depending on clinical progress: a) stinging; b) chronic cardiac insufficiency.
II. according to expressiveness of clinical displays cardiac insufficiency can be hidden (compensated) or overt (uncompensated).
III. Depending of primary breach of function this or an other section of heart it can be: left ventricle, right ventricle and total cardiac insufficiency.
IV. According to pathogenesis it can be:
cardiac insufficiency because of overloading;
cardiac insufficiency of miocardial;
extramiocardial cardiac insufficiency.
27.5 Give short characteristic of different pathogenic variants of cardiac insufficiency.
I. Cardiac insufficiency because of overloading develops as a result of effect of big leadings by resistance or volume on healthy heart, that is when the resistance to cardiac outflow or stream of blood to certain part of heart increases. It can be arouse with the valvular disease of the heart, high blood pressure, hypertension of systemic circulation lesser circulation of the blood, arterio-vein fistulas or during making vary difficult physical job. According this decrease (to the heart with normal) an extraordinary demands requires from heart with normal contractility.
II. Cardiac insufficiency of miocardium develops as a result of primary affection of miocardium. It can be related with:
a) an injury of conducting system of heart (arrhythmical) and b) an injury of fibers of working miocardium (myocardiopathic). The reasons of its development are infections, intoxication, hypoxia, avitaminosis, breaches of veins blood circulation, some hereditary defects of metabolism. Such diseases cause insufficiency even with normal or reduced leading on heart.
III. Extramiocardial cardiac insufficiency develops as a result of effect of reasons which are not connected directly with miocardium. Its rise can be caused by reduction of blood stream to heart (hypovolemia, collapse) or obstacle to realization of diastole as a result of which the heart can not accept all the blood which comes to it (accumulation of exudate or transsudate in the cavity of pericardium, stinging obstruction of heart).