CIRCULATORY FAILURE
•The main function  of circulation is keep  a good organ and tissue perfusion
•
•        BP = CO  x TPR
•Circulatory failure is a generalized inadequate blood flow in the body that causes tissue damage
due to reduced blood flow - reduced transport of oxygen (and other nutritional factors). The
cardiovascular system itself (cardiac muscle, vascular walls, vasomotor system, and other parts of
circulation) worsens when coming „circulatory shock“

CIRCULATORY FAILURE
•        BP = CO  x TPR
•CO decrease:
ülower volume in circulation – lower venous return
•decrease of filling pressure and by Frank- Starling principle decrease of CO
•Clinical: e.g. hemorrhagic shock, hypovolemic shock
•Therapy: infusion (e.g. of physiological solution)

CIRCULATORY FAILURE
•        BP = CO  x TPR
•CO decrease:
üvasodilatation of venous system - sudden periphery vasodilatation – e.g. sudden loss of vasomotor
tone : vasomotor syncope (neurogenic shock-brain damage, deep anesthesia)
üemotional activation of parasympathetic signals to slow the heart and also activation of inverse
sympathetic signals to dilate the peripheral vasculature : vasovagal syncope (emotional
disturbance-fainting in young people)

CIRCULATORY FAILURE
•        BP = CO  x TPR
•CO decrease:
ülower pumping function of the heart
•e.g. myocardial infarction, severe dysfunction of the heart valves, cardiac arrhythmias
•Result: cardiogenic shock
•= circulatory shock, which results from the weakened ability of the heart as a pump;
(85% of people who develop a cardiogenic shock will not survive)

CIRCULATORY FAILURE
•BP = CO x TPR
•Circulatory shock without the change of CO
•Abnormal increase in metabolic demands of the organism (so great that physiological CO is
insufficient)
•Abnormal tissue perfusion – e.g. septic shock (blood poisoning)
•(inadequate supply of nutrients or inadequate production of waste substances from tissues)
•

CIRCULATORY FAILURE
•        BP = CO  x TPR
•TPR decrease:
ütoxic vasodilatation (by histamin-allergy) – anaphylactic shock  - sting by a bee
ü
üDysbalance of autonomy nervous system – sympathetic part – decrease  of sympathetic tone of
vessels vegetative collapse - dysbalance of the autonomic nervous system (decrease in the influence
of sympathetic to the vascular tone – everything is related to the situations described in
vasodilation of the venous system)
ü
ü

NYHA classification
Clipboard07.bmp


•SYNCOPE - a manifestation of brain ischemia that arises with a sudden drop in blood pressure due
to failure in circulation
   - if the lying - consciousness returns quickly - within one minute • Syncope is defined as a
transient loss of consciousness  due to cerebral hypoperfusion, characterized by a rapid onset,
short duration, and spontaneous complete recovery

•If the pressure drops for several hours, they are metabolic changes in the ischemic organs and
developing „a shock“
•SHOCK = is acute circulatory insufficiency syndrome with manifestations of tissue ischemia in a
different areas of the body

Mvc MvcC MvcF
Tilt table test
(head-up tilt table test)