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Left-sided heart failure

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Illustrations

Heart, section through the middle
Heart, section through the middle
Heart, front view
Heart, front view

Alternative Names    Return to top

Congestive heart failure - left

Definition    Return to top

Left-sided heart failure is a life-threatening condition in which the left side of the heart cannot pump enough blood to the body.

Causes    Return to top

Heart failure may affect the right side, the left side, or both sides of the heart. The left side of the heart receives blood rich in oxygen from the lungs and pumps it to the remainder of the body. As the ability to pump blood forward from the left side of the heart is decreased, the remainder of the body does not receive enough oxygen especially when exercising. This results in fatigue.

In addition, the pressure in the veins of the lung increases, which may cause fluid accumulation in the lung. This results in shortness of breath and pulmonary edema.

Common causes of left-sided failure include the following:

In children, common causes include heart birth defects such as abnormal heart valves, abnormal blood vessel connections, or viral infections.

Left-sided heart failure occurs in approximately 1 to 3 of every 100 people and becomes more prevalent with age.

Symptoms    Return to top

Exams and Tests    Return to top

Physical examination may reveal an irregular or rapid heartbeat and increased rate of breathing. Listening to the heart may reveal heart murmurs or extra heart sounds, and listening to the lungs may reveal crackles or decreased breath sounds at the bottom. The skin of the legs may have excessive fluid and may remain dimpled when pressed.

Tests may include the following:

Treatment    Return to top

The goals of treatments are:

You should see a heart specialist. You may need to stay in the hospital when symptoms are severe.

Treatment may involve surgery or cardiac catheterization to open blocked heart arteries, medicines for high blood pressure, and lifestyle changes such as stopping drinking alcohol.

Persons with heart failure should eat less salt, avoid alcohol, and exercise moderately.

Medicines that may be used include:

In severe cases, medicines are given through an IV (intravenous) line in your arm.

When heart function decreases significantly, a defibrillator may be recommended to prevent sudden cardiac death. A defibrillator is used to prevent dangerous heart rhythms, which often occur in people with very weak hearts.

A number of studies have shown that heart failure symptoms can be improved with a special type of pacemaker. It paces both the right and left sides of heart. This is referred to as biventricular pacing or cardiac resynchronization therapy. Ask your provider if you are a candidate for this.

In very severe cases, when medicines alone do not work, a heart pump (ventricular assist device) can be implanted. A heart transplant may be needed.

Outlook (Prognosis)    Return to top

Heart failure is a serious condition that can result in early death. How well a person does depends on the cause of the heart failure, as well as the person's age and ability to tolerate exercise.

In many cases, there is little chance that the heart will fully recover. However, many forms of heart failure are well controlled with medication and the condition can remain stable for many years with only occasional flare ups of symptoms.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if symptoms indicating congestive heart failure occur.

Call your health care provider or get to the emergency room if symptoms are severe or if you experience chest pain, weakness, fainting, rapid or irregular heartbeat, increased cough or sputum production, sudden weight gain, or swelling.

Call your baby's health care provider if the infant has weight loss, poor feeding, or does not appear to be growing or developing normally.

Prevention    Return to top

Follow your health care provider's advice for treatment of conditions that may cause congestive heart failure. Follow dietary guidelines and minimize or eliminate smoking and alcohol consumption.

Update Date: 7/17/2006

Updated by: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.

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