What is left ventricular failure... Early recognition of the development of heart disease is limited by two factors:
The first is because patients often remain asymptomatic despite the presence of advanced infection.
The second is the limited diversity of symptoms that are attributed to heart diseases, which makes the different cases often appear similar to each other.
In this article, we will present to you a set of symptoms and signs that occur in heart failure, especially left heart failure…
What is left ventricular failure?
Heart failure describes a condition that develops when the heart is unable to maintain adequate cardiac output, or when it can do so only at the expense of high filling pressures.
The prevalence of the disease increases from about 1% in the age group of 50-59 years, to reach 5-10% in the ages of 80-89 years.
The prognosis is poor overall because about 50% of patients with severe heart failure caused by poor left ventricular function die within two years.
In many of them, deaths are due to ventricular arrhythmias or infarction.
Almost all cardiac lesions may eventually lead to heart failure.
Cardiac output is determined by preload (preload), post-load (afterload), and myocardial contractility.
When cardiac output is reduced, activation of the renin-angiotensin system leads to vasoconstriction, water and sodium retention, and then activation of the sympathetic nervous system.
Patterns of heart failure, and ventricular failure:
left.
right hand.
Biventricular.
Poor diastolic function.
High output.
compensator.
Acute left ventricular heart failure
Heart failure What is acute left ventricular failure?
It usually presents with sudden onset of shortness of breath at rest, with severe shortness of breath.
Intussusception and general physical collapse.
There may be an obvious absolute factor from the pathology such as an acute infarction.
The patient appears agitated and pales with cold sweats, as a result of the drop in arterial pressure.
The extremities are cold to palpation, the pulse is rapid, and the jugular venous pressure is usually elevated.
The location of the apex blow does not change, because there is not enough time for ventricular dilatation to occur.
Auscultation may reveal the presence of a tripartite rhythm and purring may be heard at the bases of the lungs.
In acute failure based on chronic insufficiency, additional manifestations of pre-existing heart failure are seen.
Possible triggers (eg, arrhythmia, medication change, and concurrent infection) should be recognized.
Chronic left ventricular heart failure:
Here the disease has a dormant and relapsing course, as it passes through periods of remission interrupted by attacks of decompensation.
Cardiac output is low, so it causes fatigue, laziness, and poor endurance of effort.
The arterial pressure is low, so the ends are cold because not enough blood reaches the peripheral organs.
It may present with dyspnea, dyspnea, paroxysmal nocturnal dysphoria, and inspiratory snoring heard above the bases of the lungs, due to pulmonary edema caused by left heart failure.
Right heart failure causes jugular venous hypertension with hepatic congestion and edema of the gravitational ends.
Edema is encountered in patients who move in the ankles, while in bedridden patients, edema accumulates in the sacral region, scrotum, and thighs.
In advanced heart failure, several non-specific complications may occur:
What is left ventricular failure?
Significant weight loss (cardiac wasting): This is due to the combination of lack of appetite and defective absorption caused by congestion in the digestive system.
Renal insufficiency: caused by poor renal perfusion due to reduced cardiac output, and this condition may be exacerbated by drug therapy with diuretics, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers.
Hypokalemia: due to diuretic therapy.
Increased potassium: may occur due to drug therapy (particularly the combination of ACE inhibitors with spironolactone) and poor renal function.
Hyponatremia: due to treatment with diuretics or due to disproportionate water retention caused by high secretion of antidiuretic hormone, it is therefore a sign of poor prognosis.
Atrial and ventricular arrhythmias: very common and may be related to electrolyte disturbances (eg, hypokalemia, hypomagnesemia).
Sudden death occurs in 50% of patients, due to ventricular arrhythmias.
measure:
Educate the patient adequately about the condition
Maintaining nutritional status.
Stop smoking.
Avoid a lot of salt and alcohol.
Regular moderate exercises.
Immunization against influenza and pneumococci.
drug therapy:
diuretics
Angiotensin-converting enzyme inhibitors.
Angiotensin receptor blockers.
Vasodilators.
beta-blockers;
ivabradine;
digoxin;
amiodarone;
The appropriate medication is selected based on the doctor’s report after the examination and its determination of the severity of the injury.
Non-pharmacological treatments:
Cardiac resynchronization.
Cardiac defibrillator implantation.
Coronal revascularization.
Heart transplantation.
Ventricular assist devices.