The reduction in contractile power of the myocardium causes the cavities of the heart to not be fully emptied, hence the residual systolic blood and the ventricular diastolic pressure rise. Alongside the aforementioned, the atrial pressure rises, and the flow of venous blood is obstructed. When the insufficiency is affecting the left ventricle, the pressure in the left atrium and pulmonary veins rises in retrograde fashion. Stasis emerges in the pulmonary circulation.
When the insufficiency is affecting the right ventricle, the pressure in the venous systemic circulation. This causes stasis in the liver, kidneys, etc, and accumulation of liquids in the intercellular spaces, which eventually leads to edema.
This theory is contested, because in cases such as adhesive pericarditis, tricuspid stenosis or in the ligation of the vena cava inferior it occurs that there is no edema for substantial amounts of time, regardless of the rise in venous pressure.
According to this theory the heart cannot contract with as much vigour as it used to, hence the cardiac debit is reduced, the renal flux is reduced and so is the glomerular filtration. In this manner, there is water and sodium retention, and as a consequence the volume of blood increases alongside the venous pressure, which eventually cause the edema.
What this theory does not account for is that it cannot explain the partial decompensations that may occur, such as for example the rise in pressure in the pulmonary circulation. According to the theory, the retention of water and sodium should have global effects on the entire circulatory system.
Hence, both methods have their flaws, and in many ways complete one-another.
Cardiac insufficiency affecting the left ventricle is characterized by engorged, congested lungs. As the lungs develop chronic stases, the lungs become more rigid and dark brown in coloration. Cardiac insufficiency affecting the right ventricle is characterized by an enlargement of the liver which increases in consistency, the liver develops red areas in the center and yellowish areas in the periphery of the lobule as a result of the lipid dystrophy. In more advanced cases cardiac cirrhosis of the liver occurs.
Cardiac insufficiency is a clinical syndrome which is characterized by the inability of the heart to pump well enough to supply all the tissues of the body with blood. Since the heart and peripheral vessels are functionally a joint system, one can also use the term cardiovascular insufficiency as well as cardiac insufficiency.
The reduction in contractile power of the myocardium causes the cavities of the heart to not be fully emptied, hence the residual systolic blood and the ventricular diastolic pressure rise. Alongside the aforementioned, the atrial pressure rises, and the flow of venous blood is obstructed.
The causes of cardiac insufficiency are multiple and include: determining factors, factors which lead to the emergence of the disease like extreme physical exertions, various infections such as acute pneumopathies, influenza, etc.
There are many cardiac insufficiency classifications being used. These classifications are used in order to help with a better understanding of the different stages and the treatment of the various stages.
Patients suffering from cardiac insufficiency are more predisposed to developing acute pneumopathy, which is favored for development due to pulmonary stasis; embolisms and pulmonary infarctions; bacterial endocarditis, etc.
The diagnosis is based on the information collected from the patient history; organic cardiopathic signs such as dyspnea, pulmonary stasis, tachycardia, galloping rhythm, coughing with hemoptoic sputum etc, are all symptoms related to the left ventricle.
Preventive non-drug based treatments include bed rest and diet. Drug based treatments vary across different stages, symptoms and various patients belonging to various age groups and specifications. Treatment is usually complex and involves utilizing drug combinations.
Acute insufficiency of the left ventricle is characterized by dyspnea which occurs mostly at night, resembling cardiac asthma or acute pulmonary edema. The earliest symptom to emerge in chronic insufficiency of the left ventricle is dyspnea.
Upon conducting an examination of the heart, one can observe the left ventricle has been displaced to the bottom left, the heart sounds are muted, fast and a galloping rhythm and systolic noise can be heard at the apex of the heart as a consequence of the functional mitral insufficiency.
Acute insufficiency of the right ventricle usually emerges as a consequence of a pulmonary embolisms. Chronic insufficiency of the right ventricle patients complain of a feeling of heaviness or pain in the right hypochondrium.
Upon conducting a heart examination, it is noted that there is tachycardia, the heart sounds have become muted, there are galloping sounds and systolic rumours in the vicinity of the xiphoid process, which all indicate a functional insufficiency of the tricuspid valve.