Question

Discuss the difference between right-sided and left-sided HF, their causes, clinical presentations, and diagnostic tests.

Answer 1

Left side and right side heart failure:

Left sided heart failure: when the left ventricie does not work or pump properly, it is termed as left sided heart failure. The left ventricle will pump blood to various organs in the body except lungs. Hence the body will not receive required blood to work efficiently. It occurs when the muscle of the left ventricle is strained and it may be the result of a heart attack. The strain on the muscle reduces the efficiency of the left ventricle so that there is backpressure into the left atrium and from there into the lungs. This leads to swelling in the lung tissues (pulmonary oedema) and resulting breathlessness. It is an acute life threatening condition.

The blood will be accumulated in the extravascular space of the lungs causing pulmonary congestion and edema. Hence the patient will find it difficult to breathe and creates shortness of breath. This conditions termed as dyspnea.

Causes:

Ischemic heart disease

Hypertension

Aortic and mitral valve diseases

primary myocardial; diseases

Signs and Symptoms:

Severe breathlessness (sudden onset)

Anxiety

Cough producing frothy sputum (sometimes blood stained)

Excess sweating

Right sided Heart failure: Right sided heart failure: In right sided head failure the right ventricle does not pump properly and hence the lungs will not receive enough blood to function. This may be due to pulmonary disease and hypertension.

Unlike Left sided heart failure it is a chronic condition, which usually develops slowly. It occurs when the right ventricle is strained and this leads to back pressure in the same kind of way but into the right atrium and the venous system. Oedema (swelling) is usually seen around the ankles but may be on the back if the casualty is in bed for long periods of time. The blood will be accumulated in the other part of the body because the right atrium cannot collect the blood due to weakness in the right ventncle. This will lead to enlargement of spleen and liver. Also protuberant edema is visualized in the legg and digestive system due to accumulation of fluid.

Signs and symptoms:

Oedema (swelling) especially in the ankles, shins or lower back

Nausea & vomiting

Abdominal pain and distension

Lethargy and tiredness.

Right and Left heart failure diagnostic tests:

Magnetic resonance imaging (MRI)

Electrocardiogram (ECG)

Myocardial biopsy

Coronary angiogram

Magnetic resonance imaging (MRI)

Echocardiogram

Stress test

Chest X-ray

Blood tests