Symptoms of left ventricular heart failure

In the recent past, right ventricular failure (PN) was identified as a separate, differentiated disease. For a long time, insufficient functioning of the heart was associated with all sorts of pathological processes taking place in the left ventricle.

For reference. As it turned out, the functioning of the right and left chambers of the heart is significantly different, as well as their anatomical configuration.

It was found that right ventricular failure is formed during malfunctions of normal blood circulation in the pulmonary circle of the blood flow, when the muscle fibers of the right ventricle do not fully work.

This disease is called by many doctors “pulmonary heart”.

This pathology is detected much less frequently than left ventricular failure, but it poses no less danger to the patient’s health. It is necessary to detect and prescribe proper treatment in time to improve the prognosis of the disease and the quality of life of the patient.

Pathology can occur acutely or in a chronic form. The acute type of right ventricular failure affects people with the following diseases:

  • Thromboembolic syndrome of the pulmonary artery in a wide form.
  • Pneumothorax – squeezing the lung with air located in the pleural cavity.
  • Paroxysm of respiratory failure.
  • An acute, extensive form of pneumonia.
  • Myocardial infarction of the heart (transmural, or extensive).
  • The inflammatory process in the myocardium.
  • Rupture of the interventricular septum.
  • Severe, prolonged paroxysm of bronchial asthma in the presence of asthmatic status.
  • An acute attack of bronchial obstructive syndrome.
  • Hydrothorax – squeezing the lung with fluid.

A chronic form of dysfunction of the right ventricle occurs when:

  • Respiratory tract diseases: bronchitis, asthma, emphysema, bronchiectasis, sarcoidosis and others.
  • Pathologies of the spinal column, in which the dynamics of the chest are impaired: curvature of the spine, ankylosing spondylitis.
  • Pathological excess weight leading to inadequate movement of the chest.
  • Heart defects, which cause overload of the right ventricle – tricuspid valve insufficiency and others.
  • Viral spinal paralysis, systemic diseases that cause damage to the connection between the nervous and muscular systems.
  • Violations occurring in the pulmonary blood flow – increased pressure in the pulmonary artery, the presence of blood clots, arteritis, malignant neoplasms, expansion of the aortic site.

Attention. Sometimes left ventricular failure primarily occurs and acts as the cause of the formation of right ventricular. This is due to the fact that during the first disease, the pressure in the pulmonary artery increases, which provokes an excessive load on the right chamber of the heart, and as a result, the formation of PN.

  • constant heart rate
  • edema of the lower extremities,
  • hepatomegaly (enlarged liver).

Swelling of the lower layers of the skin is gradually expressed more and more, it begins to move upward, to the femoral and lumbar regions, abdomen, and sometimes to the hands.

For reference. Edema tends to move in the lower direction, which is why in patients with a sedentary lifestyle, fluid accumulates on the lower extremities, and in lying patients – on the lower back.

There is also an accumulation of fluid in the pleural cavity, and it can be present only on one side or both at once. Swelling of the abdomen is usually found in patients who have long been suffering from PN.

If right ventricular failure has developed in connection with the inflammatory process in the pericardium, accompanied by a compaction of its inner leaf, swelling of the abdominal cavity is much more pronounced and develops much earlier. The accumulation of fluid in the pericardium does not manifest itself too much, so it is not clinically detected.

When examining a patient, the doctor observes hepatomegaly, during palpation of the liver a person feels pain.

For reference. Strong pain under the right ribs is due to the expansion of the lining of the liver, they are characteristic for dynamically progressing right ventricular failure. In addition, the patient experiences a feeling of heaviness in this area.

The functioning of the liver remains within the normal range, but occasionally there are cases of increased concentrations of bilirubin in the blood. If PN has a very long course, the formation of cardiac cirrhosis is possible, in some patients – jaundice. Less often, right ventricular failure causes the death of liver sites, failure of its functioning and extensive jaundice.

For reference. Bright symptoms of right ventricular failure:

  • low local temperature of the legs and arms,
  • blue skin
  • an increase in the venous cervical network.

At first, veins increase only when the patient is lying down. Gradually, this manifests itself in a sitting position. When the doctor palpates the liver, the pressure in the veins increases, the cervical venous network swells. The duration of the blood flow in circles increased.

One of the symptoms is also the allocation of most of the daily urine at night, as well as a reduced amount of urine excreted. A certain concentration of proteins is also found in the urine. Also, the patient has a decrease in appetite, pain in the epigastric region. Sometimes signs of oxygen starvation of the brain are found.

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Diagnostics

All diagnostic procedures should be in the hospital, since the pathology is quite insidious, and at any time it may be necessary to provide urgent medical care.

The following diagnostic measures are performed primarily:

  • Electrocardiographic study. Recorded indicators of overload of the right ventricle: T waves have a negative value in the right chest leads, and also on the lower border of the LV. There is also a complete or relative blockage of the right leg of the His bundle, signs of thromboembolic syndrome – the S wave has great depth in the first lead, and the Q wave in the third lead. Even on the electrocardiogram, a high P wave with a sharp end in all leads is always recorded, which indicates excessive work of the right atrium.
  • X-ray examination of the chest organs. It allows you to detect the accumulation of exudate or air in the pleural cavity, pulmonary edema, as well as inflammation.
  • An ultrasound examination provides accurate information if there is stagnation of blood in the liver vessels, when pain under the right ribs is the only symptom of PN.

When the patient is placed in a hospital, an echocardioscopic examination, Holter monitoring, constant monitoring of blood pressure, a blood test for troponins, creatine kinase, D-dimers, and a respiratory function test are performed in the presence of bronchial obstruction syndrome or bronchial asthma.

For reference. The diagnosis is usually made after an ECG and X-ray examination and based on an anamnesis. The remaining diagnostic methods are prescribed individually and depend on the leading diseases.

The acute form is provoked by conditions when the movement of blood in a small circle of blood flow is sharply impeded. What can affect the deterioration of blood flow in this area:

  • Asthmatic status;
  • Thromboembolic syndrome of the pulmonary artery;
  • Emphysema of the mediastinum;
  • Collapse of the alveoli;
  • Exudation in the chest cavity;
  • Respiratory distress in newborns;
  • Respiratory failure.

An exacerbation is characterized by the following symptoms:

  • swelling of the lower extremities;
  • dyspnea;
  • asphyxia;
  • blue skin;
  • sinus heart rate;
  • swelling of the cervical venous network;
  • hepatomegaly;
  • arrhythmia;
  • pain on the right under the ribs;
  • respiratory distress;
  • cold sweat;
  • stretching the membranes of the right ventricle;
  • increased central pressure in the veins;
  • increase in heart rate.

For reference. The disease develops completely unexpectedly. Initially, the patient complains of the symptoms of the disease, which caused the formation of the acute form of PN. Blood stasis in a large circle causes renal failure. Liver function is also disturbed.

Sometimes there is a sudden decrease in blood pressure, which causes a shock condition. Due to obstructed blood flow, acrocyanosis is detected.

If paroxysm of acute right ventricular failure is detected, you should immediately call an ambulance.

You can’t lose time waiting for the doctors – you need to lay the person down and give the head a vertical position, for this you can put several pillows under the head.

If there is consciousness, check with the victim the names of the medicines that he takes and provide them with them (for example, give the patient an inhaler for bronchial asthma).

The arrived medical assistant first of all carries out oxygen therapy through a special mask.

If the patient has asthma – aminophylline and prednisone are injected into the vein, heart attack – analgesic drugs and nitrates under the tongue, thromboembolic syndrome – heparin and fibrinolytic drugs are administered. After this, the patient is hospitalized in the intensive care unit or cardiology.

levozheludochkovaya nedostatochnost 2 - Symptoms of left ventricular heart failure

For reference. In the hospital, the choice of therapy depends on the underlying disease. In the presence of pneumonia, antibacterial drugs are administered to the patient, the accumulation of exudate/air in the pleural cavity is considered an indication for pleural puncture to remove effusion or air.

After bringing the person’s state to a stable state, the problem of selecting the proper treatment is solved, the purpose of which is to prevent heart failure and the formation of a “pulmonary heart”.

This is necessary to restore normal oxygen nutrition of all internal organs, in particular – the brain.

For reference. In the presence of cardiac defects, it is advisable to carry out a surgical operation, carefully weighing the purpose and contraindications to it. The best time period for the operation is selected by the heart surgeon.

In addition to treatment aimed at the factor of the onset of PN, the patient is prescribed to take certain groups of medications throughout his life. The need for this condition is due to the fact that in the absence of treatment decompensation develops, treatable only in stationary conditions.

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This condition entails negative consequences regarding the work of the heart.

Attention. Typically, diuretics, slow calcium channel blockers, nitrates are prescribed. These drugs reduce the amount of blood supplied to the right atrium, help increase the lumen of the distal vessels, lowering the pressure in the pulmonary vasculature.

Possible types

Acute left ventricular failure is manifested by a sharp increase in symptoms. The syndrome causes complications, such as pulmonary edema, cardiac asthma, or cardiogenic shock. Pulmonary edema can also cause right ventricular failure. These are very severe symptoms in which a person should be given emergency care.

0e48c1690a30fbd71a59838ee0195aa2 - Symptoms of left ventricular heart failure

Chronic left ventricular failure has a more moderate pathogenesis. Its first signs are stagnation of blood. Blood contains a low concentration of oxygen, which causes other organs to suffer. First of all, it concerns the kidneys. Violation of their work entails swelling of the lower extremities. If symptoms continue to increase, then the edema rises into the abdominal cavity and is manifested by ascites.

Stages

  • Initial. The first stage is often invisible. The syndrome can be noticed only with physical exertion. At rest, symptoms are absent. ECG changed.
  • Medium. The clinic of this stage constantly worries the patient. The syndrome makes itself felt even at rest.
  • Heavy. The pathogenesis of the last stage leads to irreversible changes in the body. Treatment at this stage gives few results.

Classification of PLWH and causes of development

Patients with severe diseases of the cardiovascular system quite often have to deal with attacks of acute heart failure.

Such conditions develop due to severe hypoxia of the tissues of organs and systems caused by the inability of the heart to pump the necessary volume of blood.

Acute heart failure provokes the development of attacks of cardiac asthma and pulmonary edema, and these conditions require the provision of timely first aid directly at the site of the patient’s condition deterioration.

Acute left ventricular failure causes stagnation in the pulmonary circulation, which is accompanied by sweating of the fluid from the bloodstream into the interstitial and perivascular space (i.e., into the lungs).

Causes

Also, an attack of acute left ventricular failure can occur against the background of:

  • anaphylactic shock;
  • pneumonia;
  • pneumothorax;
  • disorders of cerebral circulation;
  • chest injuries;
  • various intoxications (for example, in case of poisoning with organophosphorus poisons or quinine).

Symptoms

5c7fdeb41abcb17063ef376410ef803b - Symptoms of left ventricular heart failure

Acute left ventricular failure is accompanied by stagnation of blood circulation in the small circle and impaired functioning of the respiratory organs.

Before the onset of the attack, the patient may experience a number of precursors: increased shortness of breath when trying to take a horizontal position, shortness of breath even with minimal physical activity, coughing and a feeling of soreness behind the sternum. Further, the clinical picture of cardiac asthma develops:

  • a feeling of lack of air (increasing shortness of breath, suffocation);
  • rapid breathing;
  • hard breathing;
  • cold sweat;
  • lips, fingertips, auricles and tip of the nose turn blue;
  • wheezing
  • dry rales when listening to the lungs.

With an attack worsening, intravascular fluid can sweat into the alveoli of the lungs and provoke pulmonary edema:

  • the patient’s breathing becomes noisy and bubbling;
  • an angry cough appears;
  • hemoptysis or frothy pink sputum;
  • cervical veins protrude;
  • blood pressure rises (in some cases);
  • peripheral edema appears;
  • arrhythmia;
  • when listening to the lungs, wet rales are detected.

During an attack, patients occupy a characteristic forced position:

  • they are sitting;
  • breathe through the mouth;
  • have difficulty breathing.

An attack of pulmonary edema can last from half an hour to a day (or more). In the absence of adequate and timely medical care, the patient develops asphyxiation and death occurs.

An attack of acute right ventricular failure develops with an excessive load on the right ventricle and is accompanied by a sharp increase in pressure in the pulmonary circulation and blood stasis in the large circle.

Causes

This condition can be triggered by various diseases and conditions or develop against a background of prolonged left ventricular failure. It can provoke it:

  • thromboembolism;
  • congenital heart valve defects;
  • cardiomyopathy;
  • pulmonary thrombosis;
  • Fallot’s tetrad;
  • Ebstein’s anomaly;
  • right ventricular myocardial infarction;
  • acute diffuse myocarditis;
  • Eisenmenger syndrome;
  • rupture of the interventricular septum during myocardial infarction;
  • rapid infusion of solutions or blood;
  • lung diseases (pneumosclerosis, pulmonary emphysema, lobar pneumonia, prolonged asthma attack, large atelectasis, spontaneous pneumothorax).

Symptoms

In a patient with acute right ventricular failure, signs and symptoms of stagnation in a large circle of blood circulation quickly appear:

  • sudden shortness of breath
  • palpitation;
  • tachycardia;
  • arrhythmia;
  • lowering blood pressure;
  • when listening to the heart, the rhythm of the gallop and the characteristic systolic murmur in the xiphoid process are determined;
  • cyanosis;
  • Plesha symptom (swelling of veins in the neck);
  • pathological pulsation in the abdominal cavity;
  • pain in the liver;
  • an increase in the size of the liver;
  • pastiness of the skin;
  • peripheral edema;
  • ascites.

These attacks may be accompanied by unsystematic dizziness, headaches, worse when trying to tilt your head or sneeze, vomiting, apathy, and insomnia.

The appearance of acute heart failure is always an occasion for emergency measures and emergency hospitalization of the patient, and when terminal conditions occur, emergency measures for cardiopulmonary resuscitation are necessary. This pathological condition can be complicated by arrhythmias, thrombosis or thromboembolism, disseminated internal blood coagulation syndrome, renal and hepatic insufficiency, cardiac arrest and death of the patient.

There are two types of disease development:

  • acute left ventricular failure;
  • chronic form.

These two types of pathological changes differ only in the rate of development and onset of symptoms.

Left ventricular heart failure proceeds in three stages:

  • Stage 1 (initial): the absence of pronounced symptoms, a slight deterioration in physical activity;
  • Stage 2 (medium): the periodic appearance of signs of LVH even at rest;
  • Stage 3 (severe): the development of irreversible processes in the body, untimely help leads to death.

The main cause of the development of LVH is stagnation of blood in the left atrium, causing the penetration of tissue fluid into the lungs or alveoli.

The occurrence of pathology is possible in the presence of concomitant heart diseases:

  • cardiac ischemia;
  • heart rhythm disorder;
  • myocardial infarction;
  • arterial hypertension;
  • defects and heart diseases;
  • cardiomyopathy;
  • mitral stenosis;
  • arteriosclerosis of blood vessels;
  • increased blood viscosity (leading to a violation of hemodynamics);
  • obstruction of the lumen of the pulmonary vein;
  • uremia;
  • cardiogenic pulmonary edema.

Decompensation of the activity of the heart can be caused by non-cardiac factors:

  • diseases of the kidneys, liver, thyroid gland, nervous system;
  • severe anemia;
  • extensive surgical intervention;
  • thyrotoxicosis;
  • previous infectious diseases, sepsis;
  • abuse of psychotropic substances, alcoholic beverages.

The chronic form of LVH occurs with severe structural myocardial disorders. Causes of the pathology can be cardiosclerosis in the post-infarction period, damage to the heart valves, cardiomyopathy.

Symptoms of left ventricular failure are determined by the causes of its development.

Acute left ventricular failure is characterized by the following symptoms:

  • sudden shortness of breath;
  • increase in blood pressure (with hypertensive crises);
  • increased heart rate (at the initial stage of the disease);
  • cough;
  • expansion of the size of the heart to the left side;
  • the appearance of a horizontal position on the electrocardiogram;
  • symptoms of cardiac asthma;
  • respiratory failure;
  • swelling of the lower extremities.

The manifestation of the chronic form of PLWH begins gradually, with the appearance of fatigue, fatigue, loss of appetite. Patients are characterized by swelling of the lower extremities, shortness of breath during physical exertion. If timely treatment is not undertaken, then the symptoms of the disease intensify, the patient’s condition worsens.

In the case of left ventricular failure on the background of acute myocardial infarction, anginal symptoms appear: constricting pain in the heart, not passing independently, pain in the forearm and left shoulder.

Often, LVH is accompanied by arterial hypotension. In this case, the characteristic symptoms appear: fainting, increased sweating, heart palpitations.

In its clinical manifestation, cardiac asthma is similar to signs of bronchial asthma. But in the first case, shortness of breath is associated with difficulty breathing, and in the second, with difficulty breathing out. With LVH, relief occurs in a seated position, or half-sitting with legs down.

Methods of diagnosis

Acute left ventricular failure is diagnosed using routine tests and other examination methods:

  • chest x-ray;
  • electrocardiogram (ECG);
  • echocardiography;
  • general and biochemical blood test;
  • visual examination of the patient.

Radiography reveals the presence of pulmonary edema, as well as the degree of organ damage. The examination method also gives an estimate of the size of the heart.

An ECG is used to determine the activity of all heart departments, diagnose myocardial infarction, detect heart rhythm disturbances, and overload the heart chambers.

The method of echocardiography is based on the use of ultrasonic waves. The examination allows you to get an image of the heart and shows its functional activity.

When signs of myocardial infarction appear, the patient is prescribed a coronarography to assess the patency of the vessels of the heart with the introduction of a certain contrast agent. In case of impaired patency, this procedure is used as a therapeutic method to restore blood circulation.

Treatment of LVH

Treatment is determined by the form of the disease. Treatment of chronic LVH is carried out in two stages:

  • elimination of the causes of decompensation of cardiac activity;
  • withdrawal of symptoms with medication.

In the presence of heart valve defects, surgical intervention is required. In severe cases, the installation of heart-lung machines or a heart transplant is performed.

Medication is prescribed to eliminate edema, relieve symptoms of shortness of breath and to support contractility of the heart.

In this case, drugs such as cardiac glycosides, ACE inhibitors, beta-blockers, diuretics of plant and synthetic origin are prescribed. The patient is shown complete emotional peace.

Treatment is prescribed individually, depending on the well-being of the patient, the form and severity of the disease.

Acute left ventricular failure requires immediate treatment. Emergency care is based on the prevention of pulmonary edema by relieving symptoms of cardiac asthma.

  1. Reducing the intensity of metabolic processes to improve the tolerance of oxygen deficiency. Morphine (reduces pressure and inhibits breathing), droperidol (a sedative drug), sodium oxybutyrate (normalizes pressure and has a calming effect in case of hypotension).
  2. Decreased reverse venous blood flow to the heart. Nitroglycerin (dilates the coronary vessels), sodium nitroprusside (taken in case of severe pulmonary edema), application of tourniquets or tight dressings on the hands.
  3. Reducing the load on the pulmonary circulation by taking diuretics. Diuretic preparations of instant action are used both orally (furosemide, uregitis), and in the form of intravenous injections.
  4. Emergency care for acute LVH in the absence of the listed drugs consists in the intravenous administration of gangioblacrators (pentamine, arfonad). The tool helps to reduce pressure in the large and small circle of blood circulation. When using such drugs, it is necessary to monitor blood pressure every 3 minutes (on a hand that is free of droppers). In case of arterial hypotension, these groups of drugs are strictly contraindicated.
  5. Oxygen therapy – inhalation with oxygen. Emergency care for PLWH will be ineffective in the absence of sufficient air in the lungs. Oxygen is delivered via a special mask or intravenous catheter.
  6. An increase in the rhythm of myocardial contraction against the background of arterial hypertension. In this case, the following are prescribed: dopmin, dobutrex.
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Overview of left ventricular failure: causes, first aid, treatment

High-quality diagnosis will allow you to start timely treatment, which will minimize complications.

Help with acute left ventricular failure requires emergency. The patient must be placed in a sitting position. If the pressure is high, then half-sitting. This will reduce the choking sensation. If pulmonary edema has developed, then inhalation with oxygen through alcohol or another antifoam is required.

The first medication is to take nitroglycerin. 1 tablet under the tongue or 1 drop of a 1% alcohol solution is recommended. If the syndrome is accompanied by a drop in systolic pressure below 100 mm RT. Art., then nitroglycerin in this case is contraindicated.

Narcotic analgesics can help cope with an attack of suffocation and relieve the condition. They have anesthetic effect, soothe the patient.

If there are no drugs at hand, treatment can be started with improvised means. Emergency care is possible by applying tourniquets to the limbs. This allows you to unload the circulatory system and reduce the load on the heart, but only if the blood pressure is not below normal. The tourniquet can be applied no longer than 15 minutes.

In some cases, bloodletting is necessary to remove congestion in the lungs. Also, swelling will help remove a warm mustard foot bath.

After stopping the attack, the patient should be taken to the hospital emergency medical care.

If treatment concerns a chronic variant of failure, it should be aimed at eliminating the main symptoms. These drugs include:

  • Diuretics They remove excess fluid from the body, which reduces edema, and supports the work of the kidneys.
  • Beta blockers. Reduce the load on the heart muscle by reducing the frequency of contractions.
  • ACE inhibitors. Expand the cavity of the heart, thereby stabilizing the pressure.
  • Glycosides. Their first function is antiarrhythmic. But they also increase the amount of ejection.
  • Nitrates. Expand blood vessels.

People suffering from various heart pathologies, patients with hypertension and myocardial infarction, often develop left ventricular failure. The main manifestation of the disease is pulmonary edema, in which there is a violation of the contractility of the left ventricular myocardium.

With the development of pathology, the left ventricle is not able to process the entire volume of blood, which provokes the overflow of pulmonary veins and capillaries. The pressure in the vessels rises, the plasma penetrates the alveoli, passing through the vascular walls.

Thus, the alveoli are filled with blood contents, and the gas present in them reacts with the liquid to form a foam. In this case, alveolar edema develops, provoking pulmonary edema.

The syndrome of left ventricular failure (LV) was called “cardiac asthma.”

From this article you will learn: the causes of left ventricular failure, what kind of disease. What methods are used to diagnose and treat pathology.

Victoria Stoyanova, category 2 doctor, head of the laboratory at the diagnostic and treatment center (2015–2016).

Left ventricular failure is a condition of the heart in which the left ventricle is not able to throw enough blood into the aorta. Because of this, venous blood stagnates in the small (pulmonary) circle of blood circulation. Circulatory disturbance in a large circle, which causes insufficient blood supply to all organs.

Chronic left ventricular failure is a dangerous pathology, which can be cured only at the initial stage.

Acute left ventricular failure often leads to death and can be cured only if doctors quickly arrived at the patient. An important role is played by correctly provided first aid.

The treatment of left ventricular failure is carried out by a cardiologist and cardiac surgeon.

Causes of pathology

Bad habits (alcoholism, smoking, drug addiction), a sedentary lifestyle, or too intense physical activity increase the risk of developing left ventricular failure. As well as frequent stresses, excessive consumption of fatty foods, overweight, old age.

The severity of symptoms depends on the stage of left ventricular failure. At the initial stage of its development, there are no symptoms, and the pathology is visible only on the ECG and ultrasound of the heart. Therefore, it is very important to undergo a preventive medical examination on time, even if nothing bothers you.

This is the constant inability of the left ventricle to completely throw out blood, which leads to impaired blood supply to all organs and stagnation of blood in the pulmonary circle.

Stage of pathology Symptoms
1 stageAre absent. There is shortness of breath and increased heart rate with strong physical exertion, which previously did not cause unpleasant sensations in the patient. However, in people who do not exercise on a regular basis, these symptoms do not have clinical significance, since shortness of breath and a strong heartbeat also appear normally with a sharp physical activity of high intensity.
Stage 2AShortness of breath and increased palpitations with moderate physical exertion (climbing stairs above 4 floors, walking for about half an hour, short jogging), swelling of the extremities, persistent dry cough, not associated with infectious diseases, blue lip tint.
Stage 2BAt this stage, right ventricular failure is also added to left ventricular failure, which is why venous blood stagnates in a large circle of blood circulation. Characteristic symptoms: shortness of breath with little physical activity (going to the store, moving around the house, household chores), and eventually and at rest, pain and heaviness in the right hypochondrium (due to impaired blood circulation, the liver increases), cyanosis of the lips, cough, attacks of cardiac asthma, ascites (edema of the abdominal cavity). Headaches and dizziness are also possible due to lack of ary cerebral circulation.
Stage 3 (terminal)All symptoms are aggravated. Changes in the heart, liver, lungs and other organs become irreversible. The cure at this stage is no longer possible.
Diagnostic method: How is pathology manifested?
On an ECGReduced T wave amplitude
Changed ST Interval
Rhythm and conduction disorders
On ultrasoundLeft ventricular ejection fraction less than 55%
Left ventricular dilatation (cavity enlargement)
Thinning or thickening of the interventricular septum (normal – from 0,8 to 1 cm)
On chest x-rayDilated lung roots
Hydrothorax (fluid in the pleural cavity) – in severe cases

Also, using these diagnostic methods, you can identify the underlying disease that provoked left ventricular failure.

Acute left ventricular failure is a sharp decrease in the effectiveness of the left ventricle. It develops during myocardial infarction, hypertensive crisis, rupture of the interventricular septum, acute stenosis of the aortic or mitral valve, acute failure of one of these valves.

Since the functioning of the left ventricle is impaired, and the right ventricle is working fine at the same time, the pressure in the pulmonary circle of blood circulation rises. In this regard, pulmonary edema occurs.

And due to a sharp circulatory disturbance, cardiogenic shock can develop in all organs.

Symptom Description
Harbingers of pulmonary edemaThe appearance of shortness of breath (if it was already present – increased), mild cough, wheezing below the shoulder blades. If the patient was lying, he assumes a forced sitting position, as in the horizontal the symptoms intensify.
Interstitial pulmonary edema (cardiac asthma)Choking, severe cough, rapid wheezing, panic, fear of death, palpitations, increased diastolic pressure. Cold sweat, swelling of veins on the neck can also be added.
Alveolar pulmonary edemaAppears either immediately after the precursors, or after the development of symptoms of cardiac asthma. The allocation of foamy pink sputum, loud wheezing, heard from a distance, suffocation, cold sweat, swollen neck veins.
Cardiogenic shockLow blood pressure, impaired consciousness or unconsciousness, accelerated heartbeat, cold extremities. In acute left ventricular failure, cardiogenic shock is combined with pulmonary edema and its symptoms (described above).

The health and life of the patient depends on the speed of providing qualified medical care, as well as on the correctness of first aid.

Acute manifestations on the ECG:

  • ST segment depression in 1, aVL and thoracic leads.
  • Deep tooth S in 3 assignment.
  • High R wave in 1 lead.
  • High and wide tooth P in 1 assignment.

Click on the photo to enlarge

The first thing to do is immediately call an ambulance or, if the patient is already in the hospital, call a doctor.

When providing first aid it is extremely important to know the blood pressure of the patient.

If the patient is lying, put him in a sitting or reclining position, always with his legs down.

Also, to relieve stress on the heart and lungs, apply tourniquets to the lower extremities (15 cm below the groin).

levozheludochkovaja serdechnaja nedostatochnost 7 1 - Symptoms of left ventricular heart failure

With cardiogenic shock, first aid is to ensure that doctors arrive as soon as possible. Call an ambulance immediately or take the person to the hospital yourself.

Treatment

It can be both medical and surgical, depending on the cause and severity.

In the chronic form of the disease, medications can be prescribed both in tablets and in injections. In the acute form, the drugs are administered as injections, inhalations are also used.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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