Left heart failure

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

Etiology
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

 * Alcohol abuse
 * Heart muscle infections
 * MI
 * High blood pressure
 * Hypothyroidism
 * Leaking or narrow heart valves.
 * Any other disease that damages the heart muscle
 * Poor left-side heart function due to prior heart attacks.

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

Symptoms

 * Cough
 * Decreased urine production
 * Difficulty lying down
 * Fatigue
 * Weakness
 * Faintness
 * Irregular or rapid pulse
 * Palpitations
 * Shortness of breath
 * Weight gain from fluid retention

Diagnosis

 * Physical examination
 * Auscultation (reveal murmurs or extra heart sounds etc)
 * Blood tests (to evaluate thyroid, liver, kidney function)
 * Chest x ray
 * Coronary angiography
 * ECG
 * Echocardiogram (ultrasound of the heart).

Treatment
Treat underlying cause, reduce symptoms, relieve stress from heart. Beta-blockers, ACEinhibitors and long acting nitrates to reduce stress on heart, Digoxin to increase muscle strength. If abnormal heart rhythm, defibrillation may be indicated.

Prognosis
Depends on cause, age and ability to exercise. Most cases, little chance that the heart will recover.