I'm trying to understand the mechanism behind heart failure. If there is ischemia in the L ventricle (LV), that means that preload will be higher in the LV. Question 1: This means that LVEDV is higher, right? And if the LV is not pumping as much blood out, LVESV should also be higher. If both LVEDV and LVESV are higher, shouldn't the stroke volume remain relatively the same? So why does stroke volume decrease in a patient with heart failure? Or does heart failure cause a huge increase in LVEDV but not as great of an increase in LVEDV? Question 2: Also, I know that in a patient with heart failure, an increase in LVEDP will increase L atrial pressure. But why does L atrial pressure increase? And why does L atrial pressure increase pulmonary vein pressure and pulmonary artery pressure? Is it because an increase in L atrial pressure will increase the pressure in the aorta, which will increase CVP, which will then increase pulm. artery pressure and thus pulm. vein pressure (since everything is in series)? Question 3: Why do all of the above cause an increase in afterload? Is it because there is more blood in both the L and R ventricles and you need more pressure to pump the blood through? Thank you.