Table 2.1 Mechanisms in congestive heart failure


Physiological responses

  1. Peripheral vasoconstriction to redistribute blood and maintain blood pressure
  2. Increase in preload and heart rate to maintain or increase cardiac output
  3. ventricular hypertrophy to increase stroke volume without increase in preload

Mechanisms of sodium and water retention leading to expansion of blood volume

Detector mechanisms

Baroreceptors
Volume receptors
Juxtaglomerular apparatus
Thirst centre
Renal blood supply

Effector mechanisms

Angiotensin
ADH
ANP
Aldosterone
Autonomic stimulation:
neural (acute phase, effects reduced in chronic situation)
humoral
Changes in renal blood flow and distribution
An unknown 'filtration factor'
Change in behaviour (e.g. reduced exercise/activity)