Left-Sided vs. Right-Sided Heart Failure

Understanding Heart Failure

Heart Anatomy:
- Left side connected to the lungs (pulmonary circulation)
- Right side connected to venous circulation
Heart Failure:
- Heart becomes weak, fails to pump blood forward
- Blood backs up causing fluid volume overload
- Signs and symptoms indicate heart failure

Function: Receives deoxygenated blood from venous system
Failure Symptoms:
- Blood congestion in venous circulation
- Increased pressure in vena cava
- Hepatic veins congested -> hepatomegaly
- Jugular Venous Distention (JVD): visible in neck veins
- Swelling: in legs, feet, abdomen (ascites)
Causes:
- Often caused by left-sided heart failure
- Increased fluid pressure from left to right side
Mnemonic (SWELLING):
- S: Swelling in legs, feet, abdomen (ascites)
- W: Weight gain (monitor daily)
- E: Edema (pitting edema in lower extremities)
- L: Large neck veins (JVD)
- L: Lethargic (weak, tired)
- I: Irregular heartbeat (risk of atrial fibrillation)
- N: Nausea (liver congestion)
- G: Girth of abdomen (swelling, fluid buildup)

Function: Pumps oxygenated blood into arterial circulation
Failure Symptoms:
- Blood backs up into lungs (pulmonary circulation)
- Most common type of heart failure
Types:
- Systolic Heart Failure:
  - Reduced ejection fraction
  - Left ventricular systolic dysfunction (squeezing phase issue)
  - Low ejection fraction (<40% indicates heart failure)
- Diastolic Heart Failure:
  - Preserved ejection fraction
  - Left ventricular diastolic dysfunction (filling phase issue)
  - Ejection fraction is normal
Mnemonic (DROWNING):
- D: Difficulty breathing
- R: Rales (crackles indicating pulmonary edema)
- O: Orthopnea (difficulty breathing lying flat)
- W: Weakness (due to inadequate cardiac output)
- N: Nocturnal paroxysmal dyspnea (sudden breathlessness at night)
- I: Increased heart rate (sinus tachycardia)
- N: Nagging cough (early indicator, watch for foamy, blood-tinged cough)
- G: Gaining weight (monitor weight for fluid overload)

Conclusion: Monitoring signs and symptoms is crucial for managing and diagnosing heart failure. Students should note the differences in symptoms between left-sided and right-sided heart failure for effective patient assessment.