HEART FAILURE: THE RELATION OF SYMPTOMS AND SIGNS TO ITS SEVERITY AND DURATION

Abstract

Current views on heart failure are discussed, without new data. When heart failure develops suddenly, blood flow and blood pressure decline, but when it develops gradually, blood pressure and cardiac output may be normal or even above the normal under resting conditions. Such elevations in flow and pressure must predispose to heart failure. When venous pressure fluctuates rapidly, edema often is seen when it is moderately elevated; when it is constantly high, as in the lungs in mitral stenosis or in the legs after ligating the vena cava, edema formation may be slight or absent. The high venous pressure, blood volume, and engorgement of lungs and liver in heart failure are considered to be due to chronic compensatory response to blood flow below the optimal for the tissues of the cardiac patient.