Heart Failure: Left sided VS Right sided
Heart failure is a clinical condition characterized by inability of the heart to pump blood efficiently enough to maintain tissue perfusion.
Left Sided Heart failure (LVF)
most common causes
- Ischemic heart disease
- Hypertension
- Aortic or Mitral valve disease
- Myocardial disease
Left sided Failure leads to low perfusion of organs
- The left side of heart supply body organs including brain. Lower perfusion to brain leads to hypoxic ischemic encephalopathy.
- In kidneys low perfusion leads to Prerenal Azotemia.
- Reduced supply to muscle leads to fatigue and tiredness.
Left sided Failure leads to Pulmonary Venous Congestion
Left atria receives venous return from lungs, as the left ventricle fails to pump blood in systemic circulation there is increase in end diastolic volume and left atrium is unable to maintain the venous reception from the lungs, hence there is Pulmonary venous congestion. This increased pressure in pulmonary vein causes pulmonary edema (heavy wet lungs). Edema fluid accumulates in alveolar space which makes gaseous exchange difficult and leads to dyspnea. Patient also complains of orthopnea and PND (paroxysmal nocturnal dyspnea).
Heart failure cells – there is leakage of hemosiderin and other iron containing particles which are phagocytosed by macrophages. These macrophages are called siderophages or heart failure cells.
...
...
Right sided Heart Failure
Left sided failure is the most common cause of right sided failure. Isolated right-side failure is seen in cor pulmonale (related to chronic lung disease).
Right sided failure causes failure in venous reception from body organs which leads to increased central venous pressure. This causes blood to build up in the veins (the blood vessels that carry blood from the organs and tissue back to the heart). The increased pressure inside the veins can push fluid out of the veins into surrounding tissue. This leads to a build-up of fluid in the legs, or less commonly in the genital area, organs or the abdomen (belly).
Increased central venous pressure Leads to-
Increased Jugular venous pressure (JVP).
Hepatomegaly (nutmeg liver) – increased liver congestion leads to centrilobular necrosis. This necrosis is replaced by fibrosis and sclerosis and is known as cardiac cirrhosis.
Congestive Splenomegaly is also seen.
Peripheral edema of the dependent parts of the body is hallmark of right sided failure. Pedal edema and peri tibial edema is often present.
...
...
Revision for today https://creativemeddoses.com/topics-list/prader-willi-syndrome-floppy-and-hungry/
Video on CHF https://www.youtube.com/watch?time_continue=140&v=dJBFCergsuM&feature=emb_logo
Buy fun review books here (these are kindle eBook’s you can download kindle on any digital device and login with Amazon accounts to read them). Have fun and please leave review.