Left-Sided vs Right-Sided Heart Failure

Overview

Heart failure occurs when the heart is unable to pump blood effectively, leading to a backup of blood and fluid overload.
Right-sided heart failure is connected to the venous system, while left-sided heart failure is connected to the lungs (pulmonary system).

Function: Receives deoxygenated blood from the venous system.
Symptoms:
- Congestion in the venous system increases pressure in the vena cava.
- Hepatic veins become congested leading to hepatomegaly.
- Jugular Venous Distention (JVD): Enlarged veins in the neck.
- Swelling in extremities (legs, feet) and abdomen, known as ascites.
Mnemonic - SWELLING:
- S: Swelling in legs, feet, abdomen (ascites).
- W: Weight gain from fluid retention.
- E: Edema, specifically pitting edema in lower extremities.
- L: Large neck veins (JVD).
- L: Lethargic due to weak heart output.
- I: Irregular heartbeat, risk of atrial fibrillation.
- N: Nausea from liver congestion.
- G: Increased girth of abdomen from liver swelling and fluid.

Function: Pumps oxygenated blood into the arterial system.
Symptoms:
- Blood backs up into pulmonary circulation causing pulmonary edema.
- Most common type of heart failure.
Types:
- Systolic Dysfunction: Reduced ejection fraction, issues with ventricle ejecting blood.
  - Ejection Fraction (EF) is normally 50% or greater, but less than 40% indicates heart failure.
- Diastolic Dysfunction: Preserved EF, ventricle can't fill properly due to stiffness.
Mnemonic - DROWNING:
- D: Difficulty breathing.
- R: Rales/crackles indicating pulmonary edema.
- O: Orthopnea, difficulty breathing when lying flat.
- W: Weakness from inadequate cardiac output.
- N: Nocturnal paroxysmal dyspnea, sudden nighttime breathlessness.
- I: Increased heart rate due to fluid overload.
- N: Nagging cough, potentially dry or productive with frothy sputum.
- G: Gaining weight, monitor for fluid retention.