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Explore the intricacies of heart failure and cardiac pathology in this 23-minute medical lecture. Delve into the definition of heart failure and examine the key factors determining cardiac output, including heart rate and stroke volume. Gain a comprehensive understanding of the intrinsic health of the myocardium, preload, and afterload concepts. Learn about end diastolic volume, ejection fraction, and the impact of systemic and pulmonary vascular resistance on cardiac function. Engage with a practical analogy comparing cardiac function to a donkey carrying goods uphill, illustrating the interplay between preload, afterload, and myocardial health. Investigate abnormal heart rhythms as potential causes of heart failure, and conclude with an explanation of high-output heart failure. This lecture provides essential knowledge for medical students and healthcare professionals seeking to deepen their understanding of cardiac pathophysiology.