Congestive Heart Failure

Definisi
• Ketidakmampuan jantung memompa darah dalam jumlah yang cukup
untuk memenuhi kebutuhan metabolik.
• Kemampuan memompa darah dalam jumlah yang cukup untuk
memenuthi kebutuhan metabolic hanya ada jika disertai peningkatan
volume diastolic filling pressure
•Congestive heart failure (CHF): a clinical syndrome in which the heart is unable to pump enough blood to meet the metabolic
needs of the body; characterized by ventricular dysfunction that results in low cardiac output

•Systolic dysfunction: CHF with reduced stroke volume and ejection fraction (EF)

•Diastolic dysfunction: CHF with reduced stroke volume and preserved ejection fraction

•Right heart failure (RHF): CHF due to right ventricular dysfunction; characterized by backward heart failure

•Left heart failure (LHF): CHF due to left ventricular dysfunction; characterized by forward heart failure

•Chronic compensated CHF: clinically compensated CHF; the patient has signs of CHF on echocardiography but is asymptomatic
or symptomatic and stable (see “Diagnostics” below)

•Acute decompensated CHF: sudden deterioration of CHF or new onset of severe CHF due to an acute cardiac condition
(e.g., myocardial infarction)
 PRESERVED, MID-RANGE,
REDUCED EJECTION FRACTION

"Home is where life begins,

fill it with memories"

HFrEF : disfungsi diastolik dan

sistolik
HFmrEF : disfungsi sistolik ringan
+ diastolik
HFpEF : > filling pressure,
Prevalensi pada negara
berkembang :
Dewasa = ± 1-2%
Populasi > 70 tahun = ≥
10%

Resiko gagal jantung

pada usia 55 tahun :
33%

28%
Pasien dengan HFpEF
:
Proporsi pasien HFpEF =
22-73%
- Lebih tua
- Wanita
- Memiliki riwayat
penyakit hipertensi dan
fibrilasi atrium
- Jarang memiliki
riwayat myocardial
 BERHUBUNGAN
DENGAN SEVERITAS

"Home is where life begins,

fill it with memories"

Killip’s stage for heart failure

Etiologi

Disfungsi sistolik  pumping

dysfunction

Disfungsi diastolic  reduced filling

Left Sided-Heart Failure
Sistolik = penyebab penurunan Ejection
Fraction
- infark miokard
- long-standing hipertensi
- Dilated cardiomyopathy
Diastolik
- concentric cardiomyopathy
- Long-standing hipertensi
- Aortic stenosis
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy = penurunan
compliance
Right-sided Heart Failure
• Sering disebabkan oleh left-sided heart failure, backflow ke paru ->
hipertensi pulmonal
• Isolated right-sided HT
• Shunting (ASD & VSD)  Concentric hipertrofi
• Chronic lung disease/ cor pulmonale  hipertensi pulmonal
Patofisiologi
Mekanisme Kompensasi
Diagnosis : kriteria Framingham
DIAGNOSIS KLINIS

Sensitivity :
Gagal jantung sistolik (97%) >
Gagal jantung diastolik (89%)

2 major criteria /
1 major + 2 minor criteria