Left-Sided Heart Failure
Overview
The last stop for oxygen-rich blood before it leaves the heart for the rest of the body is the organ’s left side, where it passes through the left atrium (top chamber) first, followed by the left ventricle (bottom chamber). Left-sided heart failure occurs when the left ventricle, which plays a key role in the heart’s pumping action, has trouble pushing out or filling with blood between beats. Left-sided heart failure is a common cause of right-sided heart failure, which occurs when the heart has trouble sending sufficient blood to the lungs to receive oxygen.
If you have heart failure, your heart continues to pump blood, but your heart will grow weaker over time and may not be able to supply enough oxygenated blood to the rest of the body. There’s no cure for heart failure, so the goal of treatment is to manage the condition, preserve quality of life and prevent heart failure from worsening.
Types
- Heart failure with reduced ejection fraction (systolic failure). This type of left-sided heart failure is when the left ventricle loses pumping power and contracts weakly, making it difficult to send blood to the body’s main artery.
- Heart failure with preserved ejection fraction (diastolic failure). With this type of left-sided heart failure, the ventricle retains its normal pumping ability but has trouble filling with blood between each heartbeat.
Symptoms
- Cough
- Fatigue
- Heart palpitations
- Lack of appetite
- Shortness of breath
- Swelling in the stomach and lower body
- Weight gain
Prevention
- You can reduce your risk for heart failure by making changes to your habits, such as eating more heart-healthy foods; avoiding foods that are high in sodium, sugar and saturated and trans fats; and participating in moderate-intensity exercise for at least 30 minutes most days of the week. Together, those actions can help you maintain a healthy weight, which is another important way to prevent heart failure. It’s also important to manage stress, kick the habit if you smoke and get at least seven hours of sleep each night, all of which benefit your heart.
- Be sure to have regular blood pressure, cholesterol and blood sugar screenings with your primary care provider (PCP). Work with your PCP or cardiologist to manage coronary artery disease, high blood pressure or diabetes, which are common causes of heart failure.
Risk Factors
- Being African American
- Being age 65 or older
- Certain chronic diseases, including diabetes, high blood pressure and coronary artery disease
- Congenital heart defects
- Excess weight
- Having had a heart attack
Diagnosis
- Medical history. You and your cardiologist will discuss your overall health, including any chronic conditions you have and how you’re managing them, and any symptoms you’ve experienced.
- Physical exam. The physician will check your vital signs, listen to your heart and lungs, and look for lower-body swelling.
- Echocardiogram. A type of ultrasound, this test can show thickening of the heart and how well it’s pumping.
- Electrocardiogram. This test records the heart’s electrical activity and can reveal a variety of information, including whether an arrhythmia is present.
- Blood tests. Levels of certain substances in the blood can indicate whether the heart is working harder than normal.
- Chest X-rays. These can show whether the heart is enlarged.
- Cardiac MRI. This imaging test can reveal the quality of blood flow through the heart and damage from a past heart attack.
- Multiple-gated acquisition scanning. You’ll receive an injection of a radioactive tracer, and a camera will take pictures as the tracer moves through your heart so your cardiologist can gauge the muscle’s pumping ability.
- Exercise stress test. After being hooked up to equipment, you’ll walk on a treadmill as speed and incline gradually increase. This test allows your cardiologist to see how your heart responds to physical exertion and whether it gets enough blood during exercise. You may receive a radioactive tracer and have images taken as it moves through the heart before and during an exercise stress test.
- Cardiac catheterization. Your cardiologist may perform this procedure to find blockages in the arteries of the heart or areas of weakness in the muscle.
Treatment
- Managing heart failure typically involves several forms of treatment, beginning with lifestyle changes. These include eating heart-healthy foods, exercising regularly, quitting smoking and losing weight.
- Heart-healthy habits complement medications, which are key to taking some of the strain off of your heart and relieving swelling and other symptoms. Your cardiologist can choose from a variety of medications to find the ones that work best for you.
- Work with your PCP, cardiologist and other healthcare providers to manage chronic health conditions that contribute to heart failure.
- If your symptoms get worse, you may need a small, implantable machine called a cardiac resynchronization therapy device to help both sides of your heart stay in sync or an implantable cardioverter defibrillator to treat arrhythmias. Severe heart failure may require implantation of a left ventricular assist device to help the heart pump enough blood to the body. If heart failure becomes life-threatening and you’ve exhausted other treatment options, a heart transplant may be necessary.
Follow-up Care
- It’s important to follow your cardiologist’s treatment recommendations and see him or her regularly for continued monitoring. Be sure to report any new or worsening symptoms so your cardiologist can adjust your treatments, if necessary.
- Work with your PCP, cardiologist and other healthcare providers to control chronic conditions that could exacerbate heart failure.
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