Low cardiac output state
The heart is a simple mechanical pump.
For this pump to work well it needs a good supply of fuel and oxygen and this is achieved through good blood supply. However, there is a second aspect which is largely ignored by cardiologists and other doctors. The heart needs to be able to convert this fuel and oxygen supply into a usable form of energy for the muscle cells to work. This is achieved by mitochondria. They take fuel and oxygen from the blood and through a complex series of biochemical reactions, including Kreb’s citric acid cycle and oxidative phosphorylation, they generate ATP, the currency of energy in the body. Each heart cell will hold between 2,000 – 3,000 mitochondria. The reason it needs so many is that the heart never gets a rest – it has to work 24/7! An interesting observation here is that the heart is rich in oxygen and mitochondria – when the latter gets switched off, this is a major risk factor for cancer. One never sees cases of primary cancer of the heart!
The heart is only responsible for 60% of blood pressure – the rest is achieved by the muscular arteries, which pick up the pressure wave generated by the heart and boost it. High blood pressure can certainly damage delicate lining of arteries and it is the repair process which causes arteriosclerosis, or hardening and narrowing of the arteries. Cholesterol is a central part of this repair process and is probably a symptom of damage to the arteries (i.e. a marker for damage), rather than the primary cause.
Heart failure is a symptoms of other things going wrong- the important thing is to identify those problems. They boil down to the following or a combination of the follow problems, in order of probability
- Poor blood supply to the heart. See Arteriosclerosis - what causes it and how to prevent it.
- Poor conversion of fuel and oxygen into ATP ie mitochondrial failure. See CFS - The Central Cause: Mitochondrial Failure.
- Not enough blood in circulation. See Anaemia.
- Valve problems - ie blood leaking back so the heart does not beat efficiently. See Valvular problems of the heart.
- Heart does not beat regularly. See Heart Dysrhythmias, Irregular Pulse, Missed beats and Palpitations.
- Part of the heart muscle has died following a myocardial infarction. See Heart attack - what it is, diagnosis, how to treat.
- Magnesium deficiency resulting in diastolic dysfuntion. The heart muscle needs magnesium to relax - without this it becomes stiff and cannot easily fill with blood during the relaxation phase. This makes it inefficient as a pump because it has to work harder. See Magnesium - treating a deficiency.
- Pericarditis - inflammation of the coverings of the heart causes pain - if this covering becomes fibrosed then it shrinks and compresses the heart so it cannot fill properly. Similarly a bleed into the pericardium cound compress the heart.
- Hole in the heart so blood bypasses the lungs. See Patent foramen ovale as a cause of fatigue.
- The heart muscle itself is diseased - e.g. Cardiomyopathy. It is likely this is caused by mitochondrial failure so. See CFS - The Central Cause: Mitochondrial Failure and /or poor antioxidant status.
- The heart cannot cope with the stress put on to it, e.g. High blood pressure, Wikipedia:Thyrotoxicosis, aortic stenosis (Valvular problems of the heart), too much blood in circulation (Wikipedia:Polycythaemia), adrenal tumour such as a phaeochromocytoma.
- Severe overwhelming infection,respiratory failure (ie insufficient oxygen), advanced age, advanced cancer or severe malnutrition will result in mitochondrial failure and therefore heart failure.
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