The Starling Curve And Cardiac Failure

The Starling11 curve originally described the increased contractility of cardiac muscle fibres in response to increased stretch; it can be extrapolated to the whole ventricle to explain the normal relationship between filling pressure and ejection fraction (Fig. 24.4). Most patients with heart failure present in phase 'A' of the relationship, and before the ventricle is grossly dilated (the decompensated phase, 'B')- While diuretic therapy improves the congestive symptoms of cardiac failure which are due to the increased filling pressure (preload), it actually reduces cardiac output in most patients. Depending on whether their predominant symptom is dyspnoea (due to pulmonary venous congestion) or fatigue (due to reduced cardiac output), patients feel better or worse. It is likely that a principal benefit of using ACE inhibitors in cardiac failure is their diuretic sparing effect.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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