Congestive heart failure (mechanism of disease) 

This is a mechanism of disease flowchart for congestive heart failure, including systolic and diastolic left heart failure as well as right heart failure. I cover the etiology, pathophysiology of these diseases.
ADDITIONAL TAGS:
Congestive heart failure
Medicine / drugs
Infectious / microbial
Biochem / hormones
Inflammation / cell damage
Signs / symptoms
Labs / tests / imaging results
Risk factors / SDOH
Trauma
Cardiovascular pathology
Respiratory pathology
Genetics / hereditary
Neoplasm / cancer
Pathophysiology
Etiology
Manifestations
↓ contractility
↓ cardiac output
Systolic ventricular dysfunction
↓ LVEF
↓ ventricular compliance
Diastolic ventricular dysfunction
↓ ventricular filling;
↑ diastolic pressure
Poor organ perfusion
↑ pulmonary arterial pressure
Left-sided heart failure
↑ R ventricular afterload
Pulmonary hypertension
Tricuspid valve regurgitation
L-to-R shunt
RV volume overload
↑ R ventricular preload
↑ LV volume and/or pressure
Backup of blood into lungs
↑ pulmonary capillary pressure → pulm congestion
↓ right-sided cardiac output
↑ venous pressure → congestion
Progressive congestion of internal organs
Peripheral pitting edema (calves, feet)
Coronary artery disease → myocardial infarction
Systemic hypertension
Chronic ↑ afterload
LV hypertrophy
↓ elasticity
Diabetes mellitus
Altered metabolism + microangiopathy + autonomic neuropathy → cardiomyocyte hypertrophy → diabetic cardiomyopathy
Decompensated valvular heart disease
Hemochromatosis
Sarcoidosis
Amyloidosis
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Constrictive pericarditis / tamponade
Right-sided heart failure
Arrhythmias
Myocarditis
Dilated cardiomyopathy
Doxorubicin, trastuzumab
Chronic alcohol; cocaine
Chagas, Cox B, HIV
IV drugs
Peripartum
Chronic obstructive pulmonary disease
Obesity
Hyperlipid
Smoking
Obstructive sleep apnea
Hypoxia
Pulmonary embolism
Cystic fibrosis
Scleroderma
Bronchiectasis
Dyspnea
Orthopnea
Pulmonary edema
Paroxysmal nocturnal dyspnea
Supine position
Airway compression / bronchospasm
Wheeze, cough (cardiac asthma)
Fluid buildup in alveoli
Bilateral basilar rales
Cool, pale lower extremities
Fluid transudation
Stretch liver capsule
Abdominal pain
Jaundice
Nausea
Low appetite
Jugular venous distension
+/- Kussmaul sign
+/- hepatojugular reflux
Hepatosplenomegaly
Cardiac cirrhosis
Ascites
Pleural effusion
Renal dysfunction
↑ RAAS
↑ sympathetic nervous system
Hypotension
↑ fluid retention
Transient ↑ pressure
↑ filtered urine at night → nocturia
Cachexia, wasting
S3 and/or S4
heart sounds
Stroke
Cardiogenic shock
Venous stasis / leg ulcers
ASD, VSD, or PDA
Forward failure
Backward failure