Left heart failure

Left heart failure . Failure of the left chambers (left ventricle ) produces stasis of the blood from the lung, giving rise to predominantly pulmonary symptoms.


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  • 1 Classification
  • 2 Clinical manifestations
  • 3 Pathogenesis
  • 4 Sources


The classification is very difficult to see independently in the clinic, since it is presented combined with the right one and classified as global or as acute edema of the lung in its most acute phase.

Clinical manifestations

  1. Insomniaand restlessness
  2. Tachycardia: The heart increases its frequency as a compensatory mechanism.
  3. Fast, labored breathing, may present with cough, foamy sputum, and streaks of blood .
  4. Dyspnea on exertion: A marked movement in dyspnea is significant for lung congestion.
  5. Orthopnea cardiac pseudoasma and acute lung edema(acute phase). These states depend on the increasing degree of pulmonary congestion and are therefore interrelated. The vital capacity is reduced when the patient is lying down. When this reduction is small, the orthopnic position manages to overcome the feeling of suffocation.
  6. Paroxysmal cardiac dyspnea with or without wheezing, cardiac asthma, etc .: it occurs frequently at night, because at bedtime the venous return (preload to the heart) increases due to reabsorption of the peripheral edema, the patient feels relief when sitting or standing. The same symptoms of cardiac asthma occur in acute lung edema , but in extreme degrees it will be described later.
  7. Bilateral basal rales: the finding of wet rales (crackles) in the lung bases is one of the most important signs in left ventricular failure.
  8. Displacement of the tip displaced: in this case it moves down and to the left, indicating the degree and size of the left ventricle.
  9. Gallop Rhythm: An unmistakable gallop sound often appears, heard louder at the tip or slightly to the right of the tip.
  10. Cheyne-Stoke respiration: characterized by alternating periods of hypernea and hardly caused by decreased oxygen deliveryto the respiratory center.


Conditions that can cause left heart failure are:

  1. Arterial hypertension
  2. Aortic valve disease (stenosis or insufficiency)
  3. Mitral valve disease (stenosis or insufficiency)
  4. Coronary artery diseasesischemic heart disease )

In these cases there is a disorder in the nutrition of the myocardium as a result of ischemia.


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