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The adaptive mechanisms may be short term ones which come into play within minutes or hours of the onset of myocardial dysfunction. These are:
Frank-Starling Mechanism
In the Frank-Starling mechanism increased preload helps in sustaining cardiac performance. Starling's law essentially means that stroke volume is related to the end-diastolic volume. Frank proposed that the greater initial left ventricular volume leads to more rapid rate of rise of pressure, greater peak pressure and faster rate of relaxation. So the Frank-Starling law accounts for increased inotropic state and increased diastolic filling.
Neuro Hormones
Activation of neurohumoral systems resulting in release of noradrenaline leading to augmentation of myocardial contractility.
Renin-Angiotensin-Aldosterone System
Activation of renin-angiotensin-aldosterone system which helps in maintaining arterial pressure and perfusion of vital organs.
Epiboly of Ectoderm Like the presumptive endodermal notochordal and mesodermal cells migrate inward the areas in the epiblast vacated through them are occupied by expansion (
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Indications for Surgery : Patients usually present with fatigue, dyspnoea and ventricular arrhythmias. If they have additional tricuspid regurgitation, pulmonary valve replacement
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