LEFT SIDED HEART FAILURE

The left ventricle of the heart no longer pumps enough blood around the body. As a result, blood builds up in the pulmonary veins (the blood vessels that carry blood away from the lungs). This causes shortness of breath, trouble breathing or coughing – especially during physical activity. Left-sided heart failure is the most common type.

LEFT SIDED HEART FAILURE FEATURES

• CNS- dizziness,headache,syncope.
• CVS – ischemic heart disease.
• renal – oliguria
• Skin - Cold, peripheral cyanosis
• Skeletal muscle : fatigue , intermittent claudication
• Blood pressure: low systolic blood pressure.
• Pulse : Weak.

OTHER SYMPTOMS OF PULMONARY CONGESTION ARE AS FOLLOWED:

• Dyspnea: Exertional, orthopnea, paroxysmal nocturnal dyspnea or dyspnea at rest.
• Exertional Cough:
• Recurrent chest infections.
• Hemoptysis.
• Pleural effusion.
• Pulmonary edema.
• Bilatera basal crepitations.

CARDIAC SIGNS:

• Left ventricular enlargement : Localized apex. ,Shifted apex out & down , Systolic bulge
• Tachycardia
• Pulsus alternans: alternating strong & weak beats
• Gallop on the apex: due to flabby ventricle.
• Murmur of functional MR: pansystolic murmur due to LV dilatation.

INVESTIGATIONS:

• X ray: Chamber enlargement. Pulmonary congestion in LSHF.
• ECG
• Echocardiography:

1. Chamber enlargement & detect the cause.
2. Paradoxical movement of the myocardium.
3. Measurement of Ejection fraction (EF) & Shortening fraction (SF)

• Cardiac catheterization: -Chamber enlargement. -Detect the cause.
• Other imaging - CT, MRI

LABORATORY:

• CBC : to detect anemia.
• Liver function tests:
• Renal function test
• Cardiac enzymes:
• Electrolytes:
• BNP

HOMOEOPATHIC MANAGEMENT:

Aurum metallicum: Heart failure after valvular lesions. Heart feels loose on walking. Sensations as if the heart stopped beating for two or three seconds, immediately followed by tumultuous rebound with sinking at the epigastrium. Oppression at the heart. Pulse rapid, feeble and irregular. Blood pressure high.

Digitalis purpurea: It is an excellent remedy for heart failure with an irregular heartbeat. Sensation as if the heart would stop beating if moved, must hold the breath and keep still. Pulse full, irregular, very slow and weak, intermitting every third, fifth, or seventh beat. Weak heart. The least movement causes violent palpitations. Frequent stitches in the heart.

Strophanthus: It is best for heart failure with oedema of the legs. The heart’s action is weak, rapid, and irregular, due to muscular debility and insufficiency. Pulse rapid, alternating with slow, weak, small irregular.

Crataegus: It is a heart tonic. Heart muscles seem flabby, and worn out. Heart weakness with oppression, stitches and insomnia. Extreme dyspnea on least exertion without much increase of pulse. Heart dilated, first sound weak. Incompetent valves, valvular murmurs.

Cardus marianus: Effective for heart failure with liver complaints. Pain pressure and stitches in the region of the heart, oppression on deep breathing.

Naja tripudians: Heart failure with weakness and valvular disorders. Visible palpitations. Damaged heart after infectious diseases.Laurocerasus: It is best for heart failure with pain in the region of the heart. There is clutching at the heart and palpitations. Pulse weak, variable, slow or irregular. Urine is retained, suppressed involuntarily with palpitations and suffocations and fainting.