[Cardiac failure in ischemic cardiopathy]
1Dipartimento Cardiologico Angelo De Gasperis, Azienda Ospedaliera Niguarda Ca' Granda, Milano.
Insights
Heart failure, a significant health issue, stems from myocardial dysfunction, often due to ischemic heart disease. Early detection through echocardiography is crucial for managing cardiac dysfunction and improving patient outcomes.
Area of Science:
- Cardiology
- Internal Medicine
- Pathophysiology
Background:
- Heart failure is a leading cause of illness and death, posing a major public health challenge.
- Myocardial dysfunction underlies heart failure, impairing the heart's ability to meet metabolic demands.
- Ischemic heart disease is the primary cause, often leading to left ventricular systolic dysfunction, but diastolic dysfunction also occurs, especially in the elderly.
Purpose of the Study:
- To highlight the significance of heart failure as a recognized health problem.
- To emphasize the role of myocardial dysfunction in cardiac failure.
- To underscore the importance of echocardiographic screening for identifying undiagnosed cases and improving therapeutic management.
Main Methods:
- Review of the pathophysiology of heart failure.
- Discussion of common causes, particularly ischemic heart disease and myocardial infarction.
- Emphasis on diagnostic approaches like echocardiography for left ventricular dysfunction.
Main Results:
- Ischemic heart disease frequently causes left ventricular systolic dysfunction and heart failure.
- Myocardial infarction can lead to ventricular remodeling, subsequent systolic and diastolic dysfunction, and heart failure.
- A significant number of patients with heart failure or left ventricular dysfunction remain undiagnosed.
Conclusions:
- Myocardial dysfunction is central to heart failure, often initiated by ischemic events.
- Echocardiographic screening is vital for identifying patients with left ventricular dysfunction.
- Improved diagnostic strategies can enhance the therapeutic management of cardiac dysfunction.
Abstract:
Heart failure is a major cause of morbidity and mortality and represents an important recognized health problem. Heart (or cardiac) failure is the pathophysiological state in which a myocardial dysfunction is frequently but non always responsible for the inability of the heart to pump blood at a rate commensurate with tissues metabolic requirements. Ischemic heart disease is the commonest cause of heart failure frequently associated with left ventricular systolic dysfunction, although some patients, particularly the elderly, have diastolic dysfunction. Coronary heart disease is responsible for left ventricular systolic dysfunction (and cardiac failure) in the acute and chronic stage. Myocardial dysfunction is usually a consequence of myocardial infarction that may lead to ventricular remodeling with compensatory dilation and hypertrophy and subsequent systolic and diastolic dysfunction resulting in heart failure. Many patients with heart failure and/or left ventricular dysfunction are unknown. The echocardiographic screening of patients with known or suspected left ventricular dysfunction remains an important topic for future clinical epidemiological research and allows for improvement of therapeutic management of patients with cardiac dysfunction.
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