According to ezhoushan.net, left ventricular failure is also known as myocardial insufficiency. The left ventricle is affected by the heart disease, and there is an inability to meet the demands of blood circulation.
What is Left Heart Failure?
The inability of the left heart to pump enough blood into the circulatory system causes blood to back up in the lungs. The symptoms of left ventricular failure are also derived from this pathophysiological process.
Heart failure usually starts in the left heart. If the disease progresses, the right heart will eventually be affected. The doctor then speaks of right heart failure. If the entire heart muscle is affected by a performance deficiency, this is referred to as global insufficiency.
The term left-sided heart failure means that the left heart has insufficient capacity or work capacity in relation to the requirements of the entire blood circulation. Depending on the degree of severity of a left insufficiency, a distinction is made between resting insufficiency and stress insufficiency. In the case of insufficiency at rest, the symptoms already occur when the patient is at rest, so in this case the left ventricular insufficiency would have progressed considerably.
Left ventricular failure can occur as an acute event or develop insidiously and chronically. There are a number of possible causes of left ventricular failure. The most important triggers of left insufficiency include coronary artery disease, CHD, and myocardial infarction.
Both clinical pictures are based on progressive sclerosis of the coronary vessels. Inflammation of the heart muscle, myocarditis, or a pathological expansion of the heart vessel, dilated cardiomyopathy, can also lead to left heart failure. Other causes include heart valve diseases, which can be congenital or acquired.
In addition, most cardiac arrhythmias have the potential to result in left ventricular failure. Arrhythmias of the heart can, but do not have to, be associated with an insufficient ejection capacity of the left heart. Acute strain on the left heart with continuous insufficiency can also occur as a result of drug side effects, as part of chemotherapy or as a result of toxic effects in sepsis.
Even an otherwise normally functioning heart can develop transient left ventricular failure due to excessive workload, for example during a hypertensive crisis.
Symptoms, Ailments & Signs
If the heart is no longer able to supply blood to the organs, various symptoms appear. Possible signs of left ventricular failure are breathing difficulties and an increased heart rate, combined with reduced exercise capacity. During the examination, the doctor can often detect a third heart sound, the so-called gallop rhythm. In severe cases, this conspicuous rhythm is noticed by those affected themselves.
This is accompanied by pathological accumulations of fluid in the lungs, in the pericardium or in the limbs. The severity of these symptoms depends on the stage of the disease. At the beginning, left ventricular failure can be noticed in particular from slight breathing difficulties, coughing fits and unusual nervousness.
This is followed by symptoms such as cold sweats and rales. Breathing is accelerated, which often results in nocturnal shortness of breath. Advanced left ventricular failure can lead to pulmonary congestion and ultimately to the development of pulmonary edema.
Due to the undersupply of muscles and brain, physical and mental performance gradually decreases, often accompanied by symptoms such as confusion, dizziness and other disturbances of consciousness. Externally, left-sided heart failure can be recognized by the blue discoloration of the skin and mucous membranes and the film of sweat on the forehead and arms.
Diagnosis & History
The diagnostics aim to find out the causes of left insufficiency and the resulting consequences, which can be reversible, but also permanently serious. First, the family doctor can initiate a basic diagnosis using an electrocardiogram, ECG or stress ECG.
Extended diagnostics must be carried out by a cardiologist or, under outpatient conditions, in a clinic. Even an ultrasound image of the heart muscle can provide indications of the degree of severity of left heart failure. The heart catheter examination, coronary angiography, is performed under local anesthesia. Already during the examination recognizable constrictions of the coronary arteries can be widened and the blood flow can be improved again.
Before any clinical examination, the anamnesis is of great importance. The patient describes his symptoms, which indicate the presence of left heart failure. Early signs of left ventricular failure are limited exercise capacity and shortness of breath. If no adequate therapy is initiated, shortness of breath and pulmonary edema, recognizable by rales on auscultation, occur as the disease progresses.
In the worst case, left heart failure can lead to the death of the affected person. For this reason, this disease must be urgently treated and examined by a doctor, so that there are no consequential damage and other complications. The patients primarily suffer from shortness of breath. The reduced supply of oxygen also leads to permanent tiredness and exhaustion.
Those affected suffer from feelings of anxiety and not infrequently also from tightness in the left side of the chest. There is also inner restlessness and loss of appetite. Those affected also often show water retention, which can have a very negative effect on everyday life. Frequent urination can also be caused by left ventricular failure. In the worst case, this disease leads to the death of the patient.
Left ventricular failure can only be treated with medication. In this case, no surgical intervention is planned. Many symptoms can be reduced by treatment. There are no complications. In serious cases, however, a heart transplant is necessary to prevent the patient from dying.
When should you go to the doctor?
If shortness of breath, rapid exhaustion and other typical signs of left heart failure are noticed, a doctor’s visit is recommended. Other alarm signs include coughing, rattling breath sounds and occasionally heart palpitations. Anyone who notices these symptoms should consult their family doctor or a cardiologist. At the latest when serious breathing difficulties or cardiovascular problems occur, this must be medically clarified. Left ventricular failure progresses progressively, which is why medical monitoring is required in any case. People who suffer from a disease of the heart or other organs in the chest and abdomen should speak to the responsible specialist if they have any unusual symptoms.
If the symptoms persist, the cardiologist should ideally be consulted immediately. Increasing symptoms are a clear warning sign that requires immediate clarification. If this happens early, the left ventricular failure can be alleviated in many cases. Therefore, the family doctor must be consulted in any case if unusual symptoms occur in the area of the cardiovascular system. In addition, the nephrologist, a gastroenterologist or a neurologist can be called in, depending on the underlying causes of the left heart failure.
Treatment & Therapy
Treatment of left ventricular failure should be based on the underlying cause. In all forms of cardiac insufficiency, therapy principles according to the guidelines of the German Medical Association should be observed.
Patients with cardiac insufficiency must limit their daily drinking to 1.5 liters in order to keep the strain on the heart as low as possible. If hypertension is present, medication is required. Various groups of drugs are available for this purpose. Sometimes it takes some time to find out the effective drug combination for lowering blood pressure.
In the case of acute left-sided heart failure due to a heart attack with pulmonary edema, a so-called bloodless bloodletting is carried out as a therapeutic measure. The venous return flow from the legs is temporarily throttled to relieve the heart. If the coronary blood flow is critical, surgery may be indicated. So-called bypasses are created at the coronaries as collateral circulation. The vascular material required for this is usually taken from the leg veins. This procedure takes place under general anesthesia, if successful, the left ventricular failure can heal completely.
The greatest risk factor after bypass surgery is renewed sclerotherapy of the vessels. Patients with left ventricular failure are advised to follow a low-salt diet and should strive for normal weight. Excessive abuse of stimulants damages the heart muscle, therefore patients with left insufficiency should avoid nicotine and alcohol.
Outlook & Forecast
Without adequate medical care, the prognosis for left ventricular failure is unfavorable. The symptoms continuously increase in intensity and scope until heart failure occurs and the patient dies prematurely. If complications occur in the further course of the disease despite treatment, the prognosis is also poor. In the worst case, the disease can also lead to the death of the patient.
With the fastest possible diagnosis and immediate medical treatment, the prospect of alleviating the existing symptoms improves. The stress on the heart must be kept as low as possible in the long term. Emotional as well as physical stress should be avoided and exertion of any kind should be reduced to a minimum. Otherwise, the risk of the outbreak of subsequent disorders and the spread of the complaints increases. Therefore, self-help measures can positively support the recovery process and should be applied immediately.
With today’s medical possibilities, there are good therapeutic approaches that allow you to continue living with the disease despite the existing cardiac insufficiency. Long-term treatment, the administration of medication, check-ups and preventive measures are absolutely necessary. Otherwise, the prospects of sustaining life will deteriorate. Everyday life must be restructured and geared to the resilience of the organism.
Heart failure can be prevented by effective treatment of diseases that can damage the heart muscle. This primarily affects coronary heart disease, hypertension and lipid metabolism disorders caused by high cholesterol levels.
In addition, risk factors should be avoided. Obesity must be reduced or obesity should not be allowed to occur in the first place. By also avoiding nicotine and excessive alcohol consumption, the risk of heart failure is significantly reduced. In this way, serious illnesses can be prevented.
Regular check-ups prevent the occurrence of possible complications or aggravations, as these are identified in good time. However, people who suffer from heart disease can also take some aftercare measures themselves, such as a healthy lifestyle with adequate sleep and exercise in the fresh air. If you experience any unusual feelings in the heart area during the aftercare, it is advisable to inform the doctor treating you immediately. Diet also plays a major role in some heart diseases, so care should be taken not to eat too much fat in this context.
You can do that yourself
Patients with left heart failure suffer from a disease that in most cases cannot be cured. Nevertheless, you can have a decisive influence on the course of your disease by changing your lifestyle, eating healthier food and exercising regularly.
While it used to be the case that patients with cardiac insufficiency should not exert themselves, today regular and appropriate exercise is recommended. There are numerous heart sports groups in which sports are practiced according to the level of performance under qualified guidance and with medical care. Another important aspect of heart failure is a healthy diet. Weight loss is often the goal. A Mediterranean diet with lots of fruit, vegetables, fish and olive oil is recommended. A lot of salt in the diet can have a bad effect on the vessels and left heart failure. On alcohol and nicotine should, if possible, be avoided altogether. After consultation with the doctor, patients with heart failure should often not drink more than a certain amount, as additional liquid puts a strain on the weakened heart.
Stress in everyday life or at work is an additional burden for the weakened heart, which should be avoided if possible. Relaxation exercises such as progressive muscle relaxation or autogenic training are also available here. Regular intake of the prescribed medication is also essential.