Chronic Heart Failure
A state in which the heart cannot deliver enough output for the body's needs at normal filling pressures, triggering neurohormonal compensations that relieve symptoms short-term but drive progression, which the key drugs are designed to block.
First principles
Heart failure is a pump problem that the body tries to fix in a self-defeating way
When the ventricle can no longer eject an adequate stroke volume, whether because the muscle is weak (reduced ejection fraction) or stiff and cannot fill (preserved ejection fraction), cardiac output falls. The body reads a low output as if it were blood loss and activates the same rescue reflexes: the sympathetic nervous system and the renin-angiotensin-aldosterone system. These raise heart rate, constrict vessels and retain salt and water to prop up output and pressure in the short term.
Educational content pending clinical review. Not medical advice.