Left-Sided Heart Disease: A Case Study

Heart failure may convey that the heart isn’t working anymore, but what it really means is that the heart isn’t pumping as well as it should be (REF). Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body’s needs for blood and oxygen (REF). At first, the heart tries to make up for this by enlarging, developing more muscle mass, and pumping faster. As this happens, the blood vessels narrow to keep blood pressure up and the body diverts blood away from less important tissues and organs to maintain flow to the heart and brain (REF). Eventually, the body and heart cannot keep up and the patient begins to feel fatigue, breathing problems, weight gain with swelling in the feet, legs, ankles or stomach, and other symptoms that eventually leads to a hospital visit. The body’s coping mechanisms give us better understanding on why many are unaware of their condition until years after the heart declines (REF).

The left side of the heart brings oxygen-rich blood from the lungs through the left atrium to the left ventricle, then out into body. When the left side of the heart is damaged or can’t pump as well, it has to work harder to send blood through the body. This causes fluid to build up in the body, especially the lungs. That’s why shortness of breath is one of the most common symptoms of heart failure. Systolic failure happens when the heart doesn’t pump out blood the way it should. Diastolic means the heart doesn’t fill back up with blood as it should. The symptoms of left sided heart failure are tachypnea, increased work of breathing, crackles initially heard in lung bases, but when severe, heard throughout the lung fields, pulmonary edema, and dullness in lung fields to finger percussion, pleural effusion detectable by reduced breath sounds at the bases of the lungs, and cyanosis.

Left-sided heart failure is the most common type of heart failure, and it is a result of left-ventricular dysfunction. This disease poses a significant threat to patients because the primary function of the left side of the heart is to provide sufficient oxygenated blood to satisfy the metabolic demands of the body’s cells. Understanding the main function of this portion of the heart will help with the understanding of other complications associated with this diseased. Left-sided heart failure is usually the result of the loss of heart muscle function, specifically in the left ventricle secondary to coronary artery disease, prolonged hypertension, or myocardial infection (Lewis et al. 2014, 766). The

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

This occurs because when the right heart fails as a forward pump, cardiac output falls, resulting in backward dumping and leading to what is commonly known as "backward failure." If the right ventricle cannot pump effectively, the volume of blood in the veins increases, leading to congestion, similar to that of left-sided failure. Venous congestion in the form of edema is often easy to see in areas of the body lower than that of the heart. The venous congestion is also the cause of swollen ankles that many patients with right-sided heart failure tend to display.

Left-sided heart failure is a life-threatening condition in which the left side of the heart cannot pump enough blood throughout the body (Left-sided heart failure, 2014). This is a very dangerous condition. If left untreated, it can lead to more problems, even death.

Congestive heart failure is an older name for heart failure. Congestive heart failure takes place when the heart is unable to maintain an adequate circulation of blood in the bodily tissues or to pump out the venous blood returned to it by the veins (Merriam-Webster). The heart is split into two distinct pumping structures, the right side of the heart and the left side of the heart. Appropriate cardiac performance involves each ventricle to extract even quantities of blood over intervals. If the volume of blood reimbursed to the heart develops more than both ventricles can manage, the heart can no longer be an efficient pump.

Right-sided heart failure can be ruled in. When the heart is backed up it produces an overload of fluid in the lungs and entire body. As fluid accumulates in the lungs it can cause chest tightness, sob, jugular vein distention and coughing which produces a pink frothy colored sputum in which patient is positive for. Although this diagnosis has strong symptomology the BNP is normal and the diagnosis of Heart failure may be ruled out. (Dunphy & Winland-Brown,

I. Description: Congestive Heart Failure is more of a syndrome than a disease. Heart failure may be classified according to the side of the heart affected, (left- or right-sided failure), or by the cardiac cycle involved, (systolic or diastolic dysfunction). (Schilling-McCann p. 176). The word "failure" refers to the heart's inability to pump enough blood to meet the body's metabolic needs. (Schilling-McCann p. 176). When the heart fails to deliver adequate blood supply edema may develop. (Cadwallader p. 1141). Where edema occurs depends on what side of the heart is failing.

There are a number of factors that lead to the etiology of a right-sided heart failure, including left-sided heart failure and chronic lung disorder. “High pulmonary pressure, or weak, or poorly contractile cardiac muscles, or both, can be responsible for decreased right ventricular emptying” (Rockwell, 1999). The left and right ventricles work together routinely in that, when the left ventricle fails to work properly; it puts the pressure on the right ventricles, weakening the right ventricle. Pulmonary hypertension is when the blood pressure in the lungs is too high, reducing the oxygen to the tissues (hypoxia), and causing the walls of the blood vessels to become inflamed and narrowed. While pulmonary hypertension continues, the right ventricle tries to compensate by expanding and thickening it walls, increasing the blood volume in the lungs and overtime weakening the right ventricle from the work overload, resulting in right-side heart failure.

A 60-year-old male, 5 days post laparoscopic cholecystectomy, is getting ready to be discharged today and is going through the final assessment. When the assessment takes place, the nurse finds that patient has a pulse of a 110 beats per minute and irregular compared to his normal 86-90 beats per minute with a regular pulse that the patient has been having since post-surgery.

Heart failure describes the heart’s inability to function properly, meaning the heart is unable to pump efficiently throughout the body. Thus causing the heart to work extra hard in order to compensate the body’s needs, but this ultimately leads to failure. And due to Mrs. Harris’s hypertension and alcohol consumption, she is now displaying signs and symptoms of congestive heart failure, as both are major risk factors. Heart failure can be seen in the left side, which is also known as congestive heart failure, and the right side of heart. The left side is typically the first side to fail, as the left ventricle is the heart’s largest chamber and the most powerful.

Heart disease, commonly known as cardiovascular disease, consists of various conditions that affect an individual’s heart. The biological system involved in heart disease is the circulatory system, which delivers oxygen and food to all the cells of the body in order to remove waste and carbon dioxide (“Heart Disease”, N.d.). The circulatory system consists of the heart, lungs, blood, and blood vessels. These conditions affect blood vessels by narrowing or blocking their passage way to the heart, which can lead to numerous types of heart conditions. There are 3 major types of blood vessels, which are the arteries, capillaries, and veins. Once any of these blood vessels are affected, many heart conditions can arise. The various conditions include:

I am a NP currently working for a Hospital Medicine group in an inpatient setting. My primary job responsibilities are to admit patients into the hospital, round on patients, provide cross cover on the patients on our service, provide cross cover on inpatients who our group is consulted to see, respond to rapid response codes, and occasionally discharge patients.

Living with heart failure can be a challenge. However when controlled, people can live normal healthy lives with heart failure by modifying lifestyle changes. Heart failure can be seen like a balloon. A balloon can be filled up with so much water and or air such as a heart. A heart can be filled with so much blood and fluid. When a balloon continuously to get filled with air, it gets bigger and bigger until it explodes. This causes water from the balloon to go everywhere. This is like the heart. When too much fluid goes to the heart by unnecessary means, the heart gets bigger and bigger. The heart is only able to carry a certain amount of fluid or oxygen. The heart distributes this fluid to other parts of the body. When the heart gets too much fluid it explodes such as the balloon the heart enlarges and has