ok everyone let's go and get started with a little bit of hard cider today we're going to go over left versus right heart failure I'm dr. Kendall Wyatt if I'm the academic content director aspect monic if you've never heard of a banach football or what we do is we take all the information you need to know and turn it into fun pictures now it's not just pictures but what we do is we take all the facts turn them into fun characters and then inside of a scene it's taught to you with a visual audio system the characters we need to know like oxytocin then oxytocin is going to become this octopus toe in seismic monic of course it's an entire scene to help you remember everything about it and how it works with pregnancy so they you can always remember all the facts today we're going to go over left versus right Hardman but first we're going to really go over some basics on how blood flow works throughout the body so you can understand heart better because understanding it makes it super simple now we're going to go over the component like I said the blood flow through the heart and then we're going to go and compare the differences left versus right super simple now I'd like to teach everything as a body system and I like to think of a fish tank you can compare the body to a fish just like a fish tank it has all these great parts it's got the fluid just like the blood and it's got the tank itself and inside there are pipes that move everything around ie air which contains oxygen just so I like the blood I can see how the body and then pipes and then of course everything needs a pump the heart itself and that's what we're going to talk about today of course when that pump fails how it backs up it's so easy to think about this stuff if you think about concepts of it rather than just trying to memorize a bunch of facts and as you can see here it goes all together filters or just like a fish tank it gets dirty you need kidney filters so just like a great fish tune you should have it needs a filter so when you think about all together you can see right here in the image it goes all together into this beautiful working system and one system helps together so they all work to compensate for each other and that's how we have to think through compensation so first off I just want to talk about blood flow now if we talk about blood flow this is super important to make sure you just have to memorize this part to know what goes on I've got this little graphic here to kind of to help you talk through it we've got the capillaries themselves and the capillaries of the tiniest little ones you can see they'll be on the left there the blue so the left little blue capillaries go into the vein yeah to the V Neil's into the veins and then of course into the inferior and superior vena cava let me turn them a little quicker here we go the inferior and superior vena cava now everything is blue because it's d oxygen and it's flowing veins essentially they're not muscular so they flow when you move they flow when you move the blood flows moving that's what actually helps the veins they have valves and in those little valves keep the blood from going backwards your course failure of valves ends up with a little thing called varicose veins very unsightly thing happens in your legs right very often your lower limbs becomes that pressure backed up on the valves and fail so when we come to me and fear in superior vena Kaiba then we go into the right atrium the right atrium then through the tricuspid valve into the right ventricle now I never get my left's and my rights very well together but you just need to remember that this left and right we're talking about anatomical position don't get that one mixed up so we come to the right atrium and into the right ventricle then it goes out to the lungs now we know that from the dominant through the pulmonary artery to the lungs pulmonary artery in the body the community carries deoxygenated blood it goes to the lungs and into Long's it goes again through the siblings and picks up oxygen it's going to dump off co2 and pick up some oxygen and then of course it comes back to the to the heart itself to be pumped out to the rest of the body so it comes from the lungs into the pulmonary vein again pulmonary veins the only vein that carries oxygenated blood into the left side of the heart now the right side of the heart doesn't have to be very very big it's not very strong because all it has to do that little lazy thing is just pump a little bit of blood of it is a lot and the lungs are just right next door that's pretty easy so the left side of there has to be big and strong because it's got to pump out through the arteries out to the entire body for perfusion so the left side of the heart is larger of course then of course at the left side of that heart fails that's where we see not enough perfusion in the body so we're coming to the pulmonary veins into the left atrium the left atrium and then we've got through the mitral valve and of course the left ventricle and the aortic valve out to the aorta from the aorta out to the arteries I'm going to get getting everything gets smaller to the tiniest piece so those from the aorta to the arterioles can then again back to the capillaries where the the Arts your capillaries and the venous capillaries create that capillary mesh it all comes together and that's where you can produce the tissues super important to make sure you memorize this blood flow now if you've got the understand the blood through the body all you have to do is look at that little diagram or think about it in your head and say well where's the problem area so if we think about exactly that problem area then we're able to see that if a piece of the if the piece of fails then everything all the fluids just going to back up right behind it just like if you have a dam we put up dams to create giant lakes so if we're talking about dams they create a big pool behind them and that's exactly what happens in the body if something fails because everything fails because it's not pumping through through the through it so just backed up all the way behind it and that's where it's really important and of course then you can talk about interventions which we're not going to go over today but we're going to definitely help you understand the two differences so when you talk about a different types of heart area there are three types of partner there's not just left and right there's also another one called high output heart bear which we're going to talk about that by the very last so we talked about left-sided heart space look at the diagram and say where is that failure area it's on the left side of the heart where we're talking about the the left atrium the left ventricle and what we're talking about the mitral valve or the aortic valve so problems on the left side of the heart and if we have a gun all outlined right here if we look at those little areas in orange inside of that box we say well there's a failure there so if it fails at any of these places everything behind it is going to have an increased amount of pressure so the pressure does build up behind it lots of pressure behind you not necessarily pressure but pooling of blood because that's just where the kind of not it's not moving past that point like a roadblock or a dam so then of course all the symptoms that you're going to see are all going to be in the lungs so what are the big kind of lungs lung ones you see inside of left-sided heart failure well this is our pick monic image so if you've never seen a Peconic I recommend going check it out the screen animates for you inside of our system is going to teach you all about it usually in about two minutes it's a little less winded than I am but you can go in and you're going to see inside of here that there's pulmonary congestion inside of our left left heart failure assessment o'clock so we're going to show you lungs with these cars that are all congested traffic because the fluid backs up in lung and then you end up with all the signs and symptoms that go along with it so you end up with that pink frothy sputum and you also see that dr. C coughing you may see wheezes and we've got our wheezing Meisel and our crackers here for wheezing and crackles which you may see you may see you just may have difficulty breathing we've got a little gifty lungs as well as this characteristic night time coffee especially when patients lay flat so if you have fishing this heart failure a really good quick assessment tool to see the severity of their heart assessment is to say hey how many pillows do you use to prop yourself up at night to basically be able to breathe or keep from coughing because they're going to feel like they need to catch the breath so I'm going to prop themselves up and that's because when we lie flat of course that pressure is going to build up even easier inside the lungs because all the return of the body and the lungs in lower limbs is pushing back on the right side of the heart with less without it doesn't require as much force so you can use that kind of thing right there to help so again here's our pulmonary congestion our little lungs character with our congested traffic to help you remember that as well and when we talk about this here's another good example of how it backs up let's just put this in a linear example here for you so we're talking this is a truncated version of everything that's through the body heart and we've got the cabbage vein communicate on both of them right heart and then we go to the lungs and then the left arm and I've marked it in red so then you can even see here with the left heart being dead our little cyclonic character well then the fluid and all the signs and symptoms almost everything you're going to see is all inside the lump it all backs up right there is one super simple because there's a low output on the other side so let's move on to right-sided heart failure so right-sided heart failure is different than my burger well dot vs. right but it's really easy to think if we look at that diagram let's go to the heart and you say where does that blow it back up so let's look at that diagram again here to let the right side of the heart all deoxygenated blood and the left side of the heart called the oxygenated blood over here as well so we say somewhere in this area the right side of the heart is going to fail basically it's not efficient maybe there's a valve failure maybe maybe you've had a previous heart attack and that area is weak maybe there's a cardio Maya because that it's increased in size because of pressure hypertension or other problems or any kind of ischemia or damage could be lots of different things but essentially that side of the heart is no longer efficient what happens well then we've got you see right here the right atrium tricuspid valve right ventricle in that pulmonary or sim Aluna valve you're going to see the problems here so where's the fluid going back up well so easy just look and say well it's right behind it and you're going to have systemic congestion but why do you have that well that's because all the fluid is between it's coming down from our toes from your capillaries in their toes and it's go all the way up from our through our veins through the phenols into the veins and veins all the way to the vena K but what happens well that pressure is it's got to basically just flow real easy but at the right side of the heart's not pumping everything else out of the right side of the heart very well and it got a road block and everything fills up behind super important to really think about the concept because then you can think about all the signs and symptoms so here is a great little great diagram again everything linear in exactly the same way and here we've got the right side of the heart in red because that essentially looks failing well right side of the heart well then everything behind in e.k the veins capillaries in the body itself is lots of fluid backing up so in a fluid backed up there what that means on the other side of the heart there's not enough output there may be decreased perfusion and decrease oxygenation possibly with leading to other problems so here's a lot of our different characters from inside of our right side heart care heart failure come on so you need to remember JPD juggy jugular venous distention so jvd it's all going to fill up in the veins that's that fluid and we've got our peripheral edamame character all inside here animated to help you remember inside of little scene you can go and hear the great story about its healthy member it forever and of course nocturia another nighttime urination a lot of because when the threat the pressure builds up and everything builds up and everything all the web flow just kind of can't drain out so another thing with right-sided heart failure is we've got a lot of weight gain because essentially what happens is that means all the fluids backing up and it's not getting circulated around as much so you're going to see weight gain and sometimes even our society's big giant swollen up belly just because a lot of food which is not able to easily flow into being very being a caver and then be pumped around the system anytime you have a patient with heart there what's the big thing you measure the heart failure well if you've got to remember those daily weights it's really important to make sure you weigh a patient every day because you can see that increase a fluid game and you can maybe then find a potential problem where there's a serious risk for severe signs and symptoms or any observation of heart failure because what happens is the fluid overload you're not able to pump it out through the kidneys as well and then you're say hello this patient's gained more than a pound today that's a serious problem so you need to be if you can be later weigh them every day and that's a really common question that is out there a lot here's our right-sided heart failure pick Monaco I'll put together with that little scene you can go learn about our jug vein character all and these them first really swollen data mama all having a great party here now the last type high output heart center high out for Clark Parker is hard to think about because it's how can you have high output but yet you're still failure well this happens in a couple of different scenarios heart failure essentially happens not just when the pump itself fails it essentially is when there's not enough oxygenated blood being pumped through the heart so what happens with high output heart failure is that there's their baby a perfect amount of fluid volume but inside of that blood it's not oxygenated very well or there's a severe problem so we see this really common with with sepsis we see it really well with anemia so anemia there's not enough red blood cells to be able to carry oxygen so then there's not enough oxygen getting to the tissues so what happens well the heart's able to pump up faster and move this fluid around but there's not enough to meet metabolic demands so then you have high output heart failure and that's where we see a lot of patients with sepsis with these tachycardias and all these fluids flowing around lots and lots and lots but it's not oxygenated well enough to get to the tissues to sustain a nice normal healthy tissue so here we've got just a couple examples we got our severe anemia here inside of our slide and then of course another example is severe hyperthyroidism is just a fluid moving moving around here you have severe tachycardia hyperthyroidism your basal metabolic rate is increased that means all your tissues need more energy more oxygen another really weird one is an ad fish that's not just there's not a fish ative of dialysis it could be if it was malfunctioning but this is a ap Fisher arteriovenous official we're essentially outside the bar outside the heart somewhere with the venous blood near Tara blood are spinning around and they're not getting pumped back to the lungs that's another one also to just kind of think about now I love to put things together with a great little question so let's try a question they see if you can easily just immediately just see how easy it is to think about using pictures to just quickly go out and grab the signs of symptoms a 67 year old female patient presents with left-sided heart failure which of the following signs and symptoms are most likely to be C select all that apply well I think just Mia dyspnea on exertion pulmonary edema or troll edema paresthesias weight gain weight loss or jugular venous distention now if we thought about this right away think about yourself left-sided heart there so that means somewhere on the left side of the heart the hardest failing that's maybe the left atrium the mitral valve the left ventricle or the aortic valve so anywhere on that left side the heart's essentially failing it's not pumping enough so everywhere behind it essentially there's going to be a fluid back and what's behind the left side of the heart the lungs so all you have to do is think about the lung pathology it's going here and then you've ease aliy lead it out all the things that test core test question writers are going to try to throw at you which are the opposites so you can quickly look at this and easily just go through and say well patient with just me upon insertion of course pulmonary edema yes pulmonary edema increased fluid inside the lungs because that's will it back up an excess pressure so it leaks out that's why you see that pink frothy sputum and of course waking we see weight gain all left and right side of heart failure another important point to mention about left-sided heart failure is that left-sided heart failure if the left side of the heart isn't working that means the right side of the heart that's trying to pump the blood to the left side of the heart needs to work harder it needs to hypertrophy and get bigger and work harder because the left side of heart's taking a break maybe forever so what happens is left-sided heart failure ultimately leads to a failure of the right side of the heart so left-sided heart failure leads to right-sided heart a super important point to think about because eventually the whole system fail and that's why this is a serious problem that you can't just ignore so here at the bottom we've got all of their little synthetic phonics to help you go in you can learn all about the interventions and everything else inside a big monic I recommend you go try it out and of course check out a lot of our other videos and of course go try out pick monic for free you go to pick Montcalm and you can try a free trial and see all these pick knowledge and you can try the ones for heart there so that's all we got we appreciate you joining in today go ahead and check out some other videos we've got lots of other topics and check them out I'm dr. Kenda Wyeth and good luck