Left-Sided Heart Failure: Causes, Symptoms, Treatment, and Prevention
Left-sided heart failure is the most common type of heart failure. It’s the kind of condition that worsens over time if not treated properly, so learning to manage the symptoms is important.
The best left-sided heart failure definition is that the left side of your heart is damaged and can’t pump as well. As a result, it has to work harder to send blood throughout your body. This condition is referred to as left ventricular failure because the left ventricle is what supplies most of the heart’s pumping power.
When it’s harder for the left ventricle to pump blood, fluid builds up in the body, particularly the lungs. This is why many people with left-sided heart failure complain about shortness of breath.
Also read: Left ventricular hypertrophy changes the structure of the working heart leading to cardiac arrest
What Are the Types of Left-Sided Heart Failure?
There are two types of left-sided heart failure: systolic heart failure and diastolic heart failure.
- Systolic heart failure: Also called reduced ejection fraction (HFrEF), it happens when the left ventricle can’t contract forcefully. Less oxygen-rich blood gets pumped out to the body when you have systolic heart failure. Instead, it flows back into the organs, leading to fluid build-up in the lungs as well as swelling in certain parts of the body.
- Diastolic heart failure: Also referred to as preserved ejection fraction (HFpEF), this is when the heart muscle actually contracts normally but the ventricles are stiff or thick and don’t relax, so the amount of blood pumped out to the body is reduced.
Ejection fraction is the term that’s used to measure the amount of blood that pumps through the ventricles. A heart’s normal ejection fraction is between 50 and 70 percent. A measurement of 40 percent or under is usually a sign of heart failure. Sometimes, people can have a normal ejection fraction reading and still have heart failure. An echocardiogram is the most common test used for measuring EF.
What Are the Symptoms of Left Ventricular Failure?
There are a number of different left-sided heart failure symptoms. As we mentioned earlier, shortness of breath occurs because of fluid backing up into the lungs. This shortness of breath often gets worse at night, so some sufferers have to sleep upright. As time goes on, left-sided heart failure can cause shortness of breath at any time of day even when resting.
Here are the other common symptoms of left ventricular failure:
- Cough: A dry, hacking cough can be an early sign, which occurs due to fluid build-up in the lungs. In later stages, the sufferer can cough up white secretions that sometimes contain blood.
- Fatigue: This is due to the heart’s inability to pump enough blood to other body parts. Arms and legs become weak. During end-stage heart failure, patients find it hard to participate in normal activities, such as walking or getting dressed. People who are at this point tend to sleep a lot.
- Chest discomfort: The heart can beat irregularly, causing discomfort. The discomfort is described as fluttering, pain, or pressure.
- Confusion: The brain receives less oxygenated blood with left-sided heart failure, so confusion or altered thinking can occur. Memory loss may also be a problem.
- Paroxysmal nocturnal dyspnea: This means that the person is awakened from sleep with difficulty breathing.
- S heart sound: This is a murmur due to a variation in blood flow.
- Cyanosis: A bluish discoloration of the skin called cyanosis can occur as a result of poor circulation from inadequate oxygenation of blood.
- Elevated pulmonary capillary wedge pressure: This means that the pressure in the small pulmonary arterial branch is higher than it should be.
- Decreased urine output: Since other parts of the body aren’t receiving blood, the body has a tendency to want to hold on to fluid.
- Weight gain: When the body holds onto more fluid, overall body weight increases.
Some of the symptoms described here are due to forward failure, which means the heart isn’t pumping enough of the blood out to other parts of the body. Fatigue, chest discomfort, and a decrease in urine are caused by forward failure.
Other symptoms, such as difficulty breathing, coughing with blood, and weight gain are a result of backward failure, which occurs when the heart isn’t receiving enough blood.
Also read: What causes chest congestion and how to get rid of it?
Causes of Left-Sided Heart Failure
There is a long list of potential left-sided heart failure causes. The most common are outlined below:
Risk Factors Associated with Left-Sided Heart Failure
As you may have guessed, there are people who are more prone to left-sided heart failure than others. Some of the left-sided heart failure risk factors are out of our control, while others are an indication of how important it is to pay attention to our overall health since we can have influence over it.
Here are some of the common risk factors:
- Blood clots: Clots in the lungs are known to lead to left-sided heart failure
- Chronic diseases: HIV, hyperthyroidism, hypothyroidism, diabetes, or a build-up of protein or iron can lead to left-sided heart failure.
- Congenital heart defects: These can prevent proper blood flow from the heart.
- Aortic stenosis: Blood flow slows and then the heart weakens when the aortic valve opening narrows.
- Cardiomyopathy: This is a hereditary condition that can lead to heart damage.
- Irregular heartbeats: Abnormal heart rhythms can weaken the heart muscle.
- Myocarditis: This is a condition that is caused by inflammation of the heart
- Pericardial constriction: This is inflammation that creates a sac covering the heart, which can scar and tighten the heart muscle.
- Previous heart attack: In some cases, this can impact the pumping of blood
- Medications: Some chemotherapy and diabetes medications may increase risk.
- Valvular heart disease: Damage to one of the four heart valves can prevent the heart from pumping blood properly.
- Viral infection: Some viral infections have the potential to damage heart muscle.
Age, gender, and race may also play a role as risk factors. Men between the ages of 50 and 70 have often experienced heart failure if they have suffered a heart attack previously. Generally, men develop left-sided heart failure more than women. African- American men seem to be at the highest risk.
Also read: Cardiomyopathy types: Dilated, hypertrophic, restrictive, ischemic, and alcoholic
Complications of Left-Sided Heart Failure
When there’s a lack of blood flow to the heart for a lengthy period of time, it can cause permanent heart muscle damage in the form of a heart attack. There are other left-sided heart failure complications, as described in the following list:
- Angina: Chest discomfort due to lack of blood flow to the heart
- Atrial fibrillation: Irregular heart rhythm, which can increase the risk of stroke and blood clots.
- Cardia cachexia: Weight loss of 7.5 percent within six months without nutritional supplementing.
- Liver damage: Fluid backup can put pressure on the liver, making it harder to function.
- Kidney damage: When kidneys receive less blood, kidney failure is possible.
- Heart valve problems: Increased pressure on the heart can impact blood from flowing in the right direction.
- Pulmonary hypertension: When the arteries that carry blood from the heart to the lungs become narrow, making it difficult for blood to flow through vessels.
- Pulmonary edema: Left-sided heart failure can cause blood to accumulate in the veins of lungs producing dangerous levels of high blood pressure within the veins. This is a possible sign of pulmonary hypertension.
- Right-sided heart failure: Blood flows back through the lungs, which can weaken the right side of the heart.
Also read: 19 foods that increase blood flow
Diagnosing Left Ventricular Heart Failure
Left-sided heart failure diagnosis can involve the use of several standard procedures, as well as advanced medical technologies. For instance, many doctors will use the common imaging test for lungs, heart, and aorta we all know as a chest X-ray. On the other hand, more sophisticated imaging, such as radionuclide, can also be used.
Here’s a brief outline of potential diagnostic procedures and technologies:
- Cardiac catheterization: A thin flexible tube is threaded through a blood vessel and into the heart and accompanied with a contrast material so that an X-ray video can show heart functioning.
- Echocardiogram: An ultrasound to take moving pictures of heart chambers and valves.
- Electrocardiogram (EKG): A measurement of electrical activity of the heart, which can help determine if there is heart enlargement or heart damage.
- Electrophysiology: A test that records the heart’s electrical activity and pathways, which can detect heart rhythm problems.
- Radionuclide imaging: A radioactive isotope is injected into a vein and a special camera records it traveling through the heart. This helps highlight areas of heart damage.
- Treadmill exercise test: A measurement of a person’s capacity to exercise and the amount of oxygen the heart provides the muscles while in motion. This can indicate the severity of left-sided heart failure and can help determine left-sided heart failure prognosis.
Treating Left-Sided Heart Failure
Left-sided heart failure treatment is all about managing symptoms, as well as addressing the underlying cause of the patient’s condition. Treatment can involve medications, lifestyle adjustments, or possibly surgery.
- Medication: Used to help improve cardiac function and treat high blood pressure and fluid build-up. Some medications can open narrowed blood vessels, promote urination, lower cholesterol, and prevent blood clots.
- Lifestyle adjustments: Usually a low-sodium, low-fat, and low cholesterol diet is recommended along with specific types of exercise.
- Surgeries and procedures: In severe cases, surgical procedures, including device implants such as a pacemaker or left ventricle assist device (LVAD) are performed. In other situations, heart repair, including heart defect improvements, artery bypass surgery, coronary bypass graft (CABG), heart reconstruction, artificial valve surgery, or dynamic cardiomyopathy can be options. Dynamic cardiomyopathy is when a muscle is taken from the back and then wound around the ventricle of the heart. The muscle is programmed to beat like the heart muscle.
- Transplants: This is surgery that is conducted when all other treatments fail. Essentially, the damaged heart is removed and a healthy heart from a deceased donor replaces it.
Prevention and Prognosis of Left-Sided Heart Failure
There are some left-sided heart failure prevention steps you can take. It is important to remember that not all risk factors can be controlled, but the following can certainly help a lot of people maintain good heart health.
- Balance sugar: Those who have diabetes need to watch what they eat and check their blood glucose level regularly.
- Eat healthily: Limiting salt, sugar, saturated fat, and cholesterol and opting to consume lots of fruit, vegetables and whole grains along with low-fat dairy is very important.
- Exercise: Moderate exercise can help circulation and decrease the level of stress on your heart.
- Maintain a healthy weight: Having a healthy weight means the heart will be less stressed.
- Regular check-ups: Getting regular check-ups so that your doctor has the ability to catch any signs or symptoms simply makes sense.
- Reduce stress: Since stress can contribute to irregular heartbeat, find ways to lower stress and anxiety.
- Substances: Reduce alcohol intake and stop smoking, as both can have a negative impact on heart health.
In addition to the above, it’s important to take any prescribed medications. If any new symptoms arise, let the doctor know as soon as possible. Left-sided heart failure prognosis can depend not only on the cause and severity of the symptoms but also on your attitude towards your health.
For those who struggle with weight, it is advisable to check your weight every day using the same scale at the same time of day. Any sudden increase in weight can make your heart condition worse. Keeping a record of your daily weight so that you can share it with your doctor can be very helpful.
If you’re diagnosed with left-sided heart failure, remember that each case is different. For instance, you might only require a few lifestyle adjustments to deal with the condition. On the other hand, your situation could require more medical attention, including medications and surgical intervention. When it comes to the heart, it’s best to be cautious — so if you or someone you love experiences symptoms of left-sided heart failure, don’t hesitate — get medical attention.
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