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High-output heart failure is a heart condition that occurs when the cardiac output is higher than normal because of increased peripheral demand. There is a circulatory overload which may lead to pulmonary edema secondary to an elevated diastolic pressure in the left ventricle .
Major factors influencing cardiac output – heart rate and stroke volume, both of which are variable. [1]In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols , Ë™, or Ë™, [2] is the volumetric flow rate of the heart's pumping output: that is, the volume of blood being pumped by a single ventricle of the heart, per unit time (usually measured ...
Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a consequence, the cardiac muscle is forced to work harder than normal. [4]
Different mechanisms are involved depending on the cause, however the common theme is that of a high cardiac output with a low or normal afterload. The output may be high due to the inefficiency in valve disease, or it may be high due to shunting of blood in left-to-right shunts and arteriovenous malformations. [citation needed]
If the heart rate is too high, cardiac output may fall due to the markedly reduced ventricular filling time. [6] Rapid rates, though they may be compensating for ischemia elsewhere, increase myocardial oxygen demand and reduce coronary blood flow, thus precipitating an ischemic heart or valvular disease. [5]
Other signs provide evidence for specific causes of pressure overload. Hypertension is diagnosed by sphygmomanometry. A narrow pulse pressure is a sign of aortic stenosis. The chest x-ray may show pulmonary hyperaemia in the case of pulmonary hypertension, and pulmonary oligemia in pulmonary stenosis.
Hypermetabolic states, such as hyperthyroidism, anemia, or high cardiac output; Volume overload status, such as severe aortic regurgitation, severe mitral regurgitation or left-to-right shunt [2] In addition, hyperactive precordium indicates this physical finding with a pathologic cause which is noted by a clinician. [3]
Enlargement of the ventricles can also occur and contributes to the enlargement and spherical shape of the failing heart. The increase in ventricular volume also causes a reduction in stroke volume due to mechanical and inefficient contraction of the heart. [4] The general effect is one of reduced cardiac output and increased strain on the heart.
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