What Is Left Ventricular Failure?
Left ventricular failure is a type of heart failure in which the left ventricle fails to pump blood forcefully to maintain cardiac output and peripheral perfusion. When left ventricular failure occurs, the ventricle is unable to contract forcefully and pump enough blood to the whole body, which compromises the blood supply of the vital and peripheral organs. In order to meet the demands of oxygen rich blood the ventricle pumps harder to compensate the oxygen supply and becomes weaker and thinner.
Due to this the blood flows backwards to the organs, which lead to fluid buildup in the lungs and other body parts.
It is also known as left sided heart failure due to which pulmonary congestion and edema develops as a result of inability of the heart to maintain the circulatory load (causes rise in pulmonary pressure). In left ventricular failure there is collection of blood in the left ventricle of the heart due to which heart is enlarged. It also causes the apex beat to be misplaced (usually found in the 5th left intercostal space in the midclavicular line approximately 6 cm to the left of midline).
What Are The Symptoms Of Left Ventricular Failure?
Initially symptoms of left ventricular failure can go unnoticed, but over time they can worsen and present themselves as mostly signs of pulmonary insufficiency. Therefore, it is important to get regular checkups done as early diagnosis and treatment can help prevent complications such as kidney or liver diseases. This condition if not diagnosed early can also cause a heart attack.
Left ventricular failure mostly occurs before right ventricular failure with signs of pulmonary congestion. The signs and symptoms include breathlessness, dyspnea (difficulty on breathing), crackles, orthopnea (difficulty in breathing when lying down flat), pallor, cold perspiration, sudden weight gain, nausea and loss of appetite. It also includes fatigue with mild to moderate exertion (reduced ability to exercise), urgency to urinate at night, swelling of the abdomen, edema of legs and decreased flow to the peripheral organs (peripheral constriction), chronic cough and pleural effusion.
Further damage can occur when the symptoms are not controlled and can lead to an enlarged heart, increased heart rate, high blood pressure and peripheral constriction (decreased flow of blood to the arms and legs).
Risk factors for left ventricular failure are smoking, obesity, chronic alcohol consumption, high salt intake, congenital heart diseases, viral infections, anemia, previous heart attack, cadiomyopathies, valvular heart diseases and certain drugs that affect the heart contractility such as beta blockers, ACE inhibitors, diuretics and digoxin.
Diagnosis of Left Ventricular Failure
The procedures used to detect left ventricular failure include chest X-ray, echocardiogram (ECG), electrocardiogram (EKG), radionuclide imaging (thallium stress test), treadmill test, electrophysical study of the heart and cardiac catheterization.
How To Prevent Left Ventricular Failure?
Although, risk factors cannot be controlled, but the left ventricular failure can be reversed and symptoms can be minimized by taking certain precautions such as lowering blood sugar in your diet, being active (moderate exercise), which helps in circulation and decreases stress on heart. Regular visits to a physician help in identifying symptoms and early diagnosis. Maintaining a healthy lifestyle by weight reduction or controlling obesity, reducing stress, alcohol intake and tobacco consumption is necessary.
Treatment and Management of Left Ventricular Failure
Managing symptoms and treatment of underlying causes is the mainstay of treatment of left sided heart failure. Medications, lifestyle changes and surgeries help prevent left ventricular failure depending on the severity of condition.
Medication will improve cardiac function by lowering fluid buildup, improving blood flow, lowering cholesterol, increased urination, reducing blood pressure and preventing clot formation.
An active lifestyle with low sodium, low fat and low cholesterol diet can be very helpful in easing the symptoms.
Lastly where medications for left ventricular failure fail and symptoms are severe surgery comes into use. Surgeries can include device implants (left ventricular assist device surgery LAVD and pacemaker), repair of heart (CABG congenital artery bypass graft, heart reconstruction surgery, congenital heart repair) or heart transplant.
Complications of left ventricular failure are angina, heart attack, damage to the liver and kidneys, and right sided heart failure.
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