Left Heart Failure

Question 1

When does LHF occur?

Answer 1

When there is damage to the left ventricular myocardium and contraction is ineffective

Question 2

What are the consequences of LHF?

Answer 2

The heart cannot pump all the blood it receives from the atrium and supply the body with adequate oxygenated blood

Question 3

What are some causes of left heart failure?

Answer 3

• Ischemia
• Hypertension
• Mitral or aortic valvular regurgitation
• Aortic stenosis
• Cardiomyopathy
• Congenital heart disorders (e.g. ventricular septal defect, patent ductus arteriosus with large shunts).

Question 4

Describe the pathogenesis of LHF

Answer 4

LHF results in pooling of blood in the atrium, causing
Pulmonary pressure to exceed oncotic pressure of plasma proteins (in the lungs) causing
fluid to extravasate (def: forces fluids out from its natural environment) into the interstitum and alveoli.
This leads to decreased pulmonary compliance, work for breathing.
The accumulation of fluid in the lungs leads to poor perfusion

Question 5

What will congested lungs lead to?

Answer 5

Increased pressure in the right heart and lead to congested heart failure

Question 6

What is the most common sign in LHF?

Answer 6

Dyspnoea (reflecting pulmonary congestion). As LVF progresses dyspnoea will become more severe and not just with exertion but at rest

Question 7

Describe other signs and symptoms of LHF

Answer 7

• orthopnoea ( Pts. Inability to breath in a supine position and relieved by sitting up
• Fatigue
• Coughing with a pink tinged sputum that may be foamy or frothy
• Poor cardiac output
• Poor perfusion of tissues
• Dyanosis and pallor
• Tachycardia
• Wheezing
• Crackles at base of the lung
• Exercise intolerance