Question

what to look for when the left side of the heart failure happens. how do you explain to the patients or what signs as shown?

Answer 1

Left side heart failure means left ventricular failure, that is left ventricle is failing to pump blood into the systemic aorta which will eventually lead to cellular death due to lack of oxygen and nutrients.

Left atrium gets the oxygenated blood from lungs. Left atrium contracts and pumps blood into left ventricle. Left ventricle pushes the oxygenated blood into the systemic aorta. Systemic aorta further divides into many branches and provide oxygen to each and every cell of body.

If left ventricle can't generate enough pressure to push blood into aorta, it won't reach the periphery and cells of the body will start dying. This will be seen as various signs and symptoms in patient. Following will be the signs and symptoms of the patient,

1. Breathlessness and palpitations,

2. Chest pain,

3. Pedal edema,

4. Excessive fatigue and dizziness,

5. Tachycardia that is increased rate of contraction of heart, but these contractions are not enough to push blood into aorta.

6. Cold and clammy extremities.

7. Smetimes dry cough can also be seen.

8. In myocardial infarction patients chest pain radiating to left arm and forearm and back are the typical symptoms

These are the general signs and symptoms seen in patient of left heart failure.

Most common cause of left ventricular failure is myocardial infarction. The arteries which supply the blood to the muscles of heart are called coronary arteries. If these arteries get blocked then the cardiac muscles will die due to deficiency of nutrients as well as oxygen. So the whole area which is supplied by that coronary artery will be dead and won't involve in contraction. This is called myocardial infarction. This myocardial infarction can be detected in patient early by conducting some blood investigations. Various cardiac muscle markers like CPK MB ( creatine phosphokinase MB), cardiac troponins, myoglobin are used to diagnose myocardial infarction.

Certain radiological investigations can also be used like 2D echocardiography. On 2D echo, we can see ejection fraction. Ejection fraction is the fraction of blood pumped out through left ventricle during systole. In normal individuals minimum 60% of the blood from the left ventricle is pushed in systemic aorta during systole. In left heart failure patients this fraction decreases below 60% and and the above mentioned symptoms and signs can be seen in the patients.

Electrocardiographic findings in left heart failure patients can be normal in 10% of individuals. Most of the ECG findings are due to myocardial infarction. Typical ECG finding in anterior wall myocardial infarction is ST segment elevation. We have to explain patient about the danger signs of left heart failure like breathlessness, palpitations, chest pain etc and ask them to visit nearest hospital during emergency.