Health and medicine
- Overview of heart failure
- What is heart failure?
- Systolic heart failure pathophysiology
- Diastolic heart failure pathophysiology
- Compensation and decompensation in heart failure
- Symptoms of left sided heart failure
- Symptoms of right sided heart failure
- Heart failure diagnosis
- Heart failure treatment - Early stages
- Heart failure treatment - Late stages
- Heart failure treatment - Devices and surgery
Symptoms of left sided heart failure
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- Does it cause wheezing in the backward failure on the Left sided heart failure(2 votes)
- Unlikely; wheezing is caused by narrowed airways as you would expect in bronchospasm.
Left sided heart failure would be more likely to cause crackles in the patients lungs than wheezing, due to the fluid buildup in the lungs.(8 votes)
- It says in my book that backward failure is increased congestion of the the venous circulation. Isn't that different to what was just explained?(2 votes)
- No, it is the same as what was described. It is pushing back on the venous circulation. The increased blood volume in the venous circulation results in fluid accumulation in the interstitial areas, also called edema.
Left heart failure means the heart is unable to eject a normal stroke volume from the left ventricle. Therefore, blood 'backs up' into the veins delivering to the left atrium, the pulmonary veins. That is the venous circulation on the left. Back pressure causes pulmonary edema, or fluid accumulation in the lungs. Right heart failure means the heart is unable to eject a normal stroke volume from the right ventricle. Therefore blood again backs up. On the right side, blood is coming into the right atrium from the superior and inferior vena cavaes. The jugular vein becomes distended, as do the esophageal veins, and the liver veins, enlarging the liver. The back pressure results in peritoneal edema (fluid accumulating and enlarging the abdomen) and dependent edema of the legs. These changes are easy to see as the belly enlarges and legs become thicker. Heart failure will typically progress so that both right and left signs will become evident. However, pulmonary edema is life threatening and less obvious. Patients may present with shortness of breath and not realized they have hypertension with heart failure. Hope this helps.(2 votes)
- If a woman is pregnant, then she has those symptoms, would it affect the child?(2 votes)
- Is it possible to be in CHF (L or R) and have wt gain but not have lower extremity edema and lab draw of NT-proBNP negative?(1 vote)
- Why there is facial puffiness in renal pathology and not in liver/heart diseases?(1 vote)
- how do you know that dyspnea is caused by pulmonary edema?(1 vote)
- What is the pathophysiology behind high blood pressure in left sided heart failure? Is it because left sided heart failure is usually caused by hypertension in the first place? I realize that there is a lot of fluid build up; but if the ejection fraction is severely reduced; why is the BP usually so high?(0 votes)
- It's because hypertension is a common cause for cardiac failure. If the heart is always pumping against an increased afterload, then over time it needs to work harder and harder to compensate. Like any other muscle, the ventricle wall gets bigger and thicker with this exercise.
When the heart stops keeping up with the demands on it, the body feels this as a decrease from what has previously been its normal blood pressure. The body tries to compensate by pushing the heart to pump faster and harder, by increasing the resistance in the peripheral vessels, and by activating the renin-angiotensin-aldosterone system to try to maintain the (pathological!) high blood pressure.(1 vote)
- [Voiceover] So Left-Sided Heart Failure means that the left side of your heart isn't pumping enough blood as it should, right. Since the left side of your heart pumps blood to your body, whereas your right side pumps blood to your lungs, the symptoms are gonna be a little different for heart failure on the left side versus the right side. And we can even further divide those symptoms of Left-Sided Heart Failure into two categories. And the first one is Forward Failure, and the second one is Backward Failure. So if we're talking about Forward Failure, we're saying that the heart is failing to pump enough blood out from the heart or forward. So the first and kind of foremost symptom, one of the big pieces of heart failure is tiredness and fatigue. So let's really quick, review how blood moves around. Usually, it comes into the left side. And then, your left side pumps it out to you, the body. And that blood has oxygen because your body needs oxygen, right. So your heart's pumping the blood out to your body to give it oxygen. Then, your body uses it up, and it gives it back to the right side of the heart, where it pumps it to the lungs. And then, that blood goes back into the left side, and that whole process repeats. So since your left side isn't pumping enough blood, enough oxygenated blood or blood with oxygen to your body, your body's gonna feel fatigued and tired because it's not getting enough oxygen, right. And because your whole body, every cell in your body needs oxygen to kind of survive. So if it's not getting enough oxygen, you're gonna feel tired. You're gonna feel fatigued. And this again is one of the hallmark symptoms of decompensated or kind of late-stage heart failure. So second symptom of Forward Failure is a decrease in urine production. That sounds kind of weird. Why would it do that? Well since your body's having trouble receiving enough blood because that left side's not pumping enough blood out, it tries to keep or hold onto the fluid to increase the amount of blood in your body. Usually any extra fluid will just be taken up by our kidneys and eliminated through your urine, right. But now your body's like, "We need more blood, "so I'm gonna hold onto this fluid." And so your urine production goes down. Finally, another symptom of Forward Failure is a rapid or irregular heartbeat. And sometimes we call these "palpitations," where it feels like your heart is suddenly racing really fast or even beating really hard. And when this seems inconsistent, either when the heart rate is beating too fast and then too slow and then too fast, or maybe it's beating really hard all of a sudden. We might call that irregular, that it's this irregular heart beat, and sometimes that can even feel like a beat was skipped. The reason this is happening is because the heart's trying to compensate for a lower pumping ability. So the heart's beating faster and harder to try to increase the amount of blood that's sent out to your body. Okay, so those were the symptoms that are caused by this inability to pump enough blood forward or out, but you can also have symptoms that are caused by this Backward Failure. And when we say Backward Failure, we mean that the heart isn't able to receive enough blood into the heart. And you start to get this backup of blood. And so most of the time, kind of manifests the symptoms of congestion or fluid buildup, and it's also why we sometimes call it congestive heart failure, so let's think about this. Fluid comes from your lungs to your heart. But if your heart's not pumping effectively, it's not pumping enough blood out. That blood's gonna start to get backed up, right. Think of it like a traffic jam. So all of a sudden, there's this one lane for all the cars to get through, and so there ends up being this huge line of cars that gets backed up. It's sort of like the same thing with fluid being backed up. And where does that blood get backed up to? Well since it's coming from the lungs, it makes sense that it gets backed up to the lungs. And this is sometimes called pulmonary edema, since that blood's being backed up into the pulmonary portion of your circulatory system, which is also your lungs. And the edema just refers to fluid buildup. So the first Backward Failure symptom or congestive symptom is this difficulty breathing. So since this fluid's being backed up into your lungs, it can fill into these alveoli, which are the parts of your lungs that help exchange oxygen. And since those are filling up with fluid instead of air, it's gonna make it a lot more difficult to breathe. And along those same lines, you might start to cough up this pink or foamy mucus. Since that fluid's filling into the lungs when it's definitely not supposed to be, your body tries to clear those lungs' airways by coughing, by coughing up the fluid. And sometimes that fluid may be tinged pink because that blood is backing up into the lungs. And these two symptoms might even get worse at night or while you're laying down since now the fluid's working less against gravity than it was when you're standing up. And those coughing fits or difficulty breathing might get worse while you're trying to sleep. Finally, some patients may notice that they're gaining weight, and this is for the same reasons that we just mentioned, so that the body's holding onto more fluid, right. So your body's gonna have all this extra fluid weight, and that's gonna be reflected in this increase in weight gain.