Pathophysiology and Definitions
The left ventricle pumps oxygenated blood to this major part of the body.
systemic circulation (or the body)?
The clinical medical term for the shortness of breath that patients with left-sided heart failure frequently experience.
dyspnea
Because blood backs up backward from the left ventricle, this organ system is the very first to be directly impacted and overloaded with fluid
pulmonary system (or the lungs)
When counting the patient's respiratory rate, a nurse will likely observe this finding as the patient attempts to take in more oxygen
tachypnea (or an elevated respiratory rate)
Checking the apical pulse of a patient compensating for low cardiac output will usually reveal this rapid rhythm
tachycardia
This measurement, normally between 50% and 70%, represents the percentage of blood leaving your heart each time it contracts and is often reduced in left-sided heart failure.
Ejection Fraction (EF)?
Patients will often report needing to sleep in a recliner or propped up on multiple pillows to avoid this specific symptom
orthopnea
Due to a drop in cardiac output and poor forward perfusion, the central nervous system suffers, leading to these early behavioral signs of hypoxia
restlessness, confusion, or agitation
To assess for hypoxia caused by fluid in the lungs, the nurse should immediately apply this non-invasive monitoring device to the patient's finger
pulse oximeter
Because the body shunts blood to vital organs, checking the patient's fingers and toes will reveal that this assessment takes longer than the normal 3 seconds
capillary refill
In left-sided heart failure, backward failure means blood backs up from the left atrium into these specific vessels.
pulmonary veins?
This symptom involves a patient waking up suddenly in the middle of the night feeling like they are suffocating or gasping for air
Paroxysmal Nocturnal Dyspnea (PND)
Because forward blood flow is weak, this organ decreases its urine production, resulting in a condition called oliguria
What are the kidneys
Auscultation of the lung bases in a patient with left-sided heart failure will most commonly reveal this adventitious sound caused by air moving through fluid
crackles
Palpation of the radial and pedal arteries will likely reveal that they feel like this, due to low stroke volume and poor forward perfusion
weak and thready (or diminished)
This type of left-sided heart failure occurs when the left ventricle is too stiff to relax and fill properly during diastole, even though it can still squeeze well.
diastolic heart failure (or HFpEF)?
Early on, a patient with left-sided heart failure may present with this type of cough, which worsens at night when lying flat
dry, hacking cough
If left-sided heart failure is left untreated, the chronic high pressure in the pulmonary system will eventually cause this secondary condition
right-sided heart failure
Sometimes heard on expiration, this high-pitched sound is caused by bronchospasm secondary to fluid overload in the airways, mimicking an airway disease.
wheezing (or cardiac asthma)
Palpating the chest wall may reveal that the Point of Maximal Impulse (PMI) has shifted to the left, indicating this structural change in the heart muscle
cardiomegaly (or left ventricular hypertrophy)
The stretching of the ventricular muscle fibers at the end of diastole, which pathologically increases as fluid backs up in a failing heart.
preload
This late-stage, hallmark manifestation indicates that fluid has leaked into the alveoli, creating a medical emergency known as acute pulmonary edema
pink, frothy sputum
In response to poor renal perfusion, the kidneys activate this hormone system, which unfortunately worsens heart failure by increasing fluid retention and vasoconstriction
RAAS (Renin-Angiotensin-Aldosterone System)
Observation of the patient's breathing may reveal this abnormal, rhythmic pattern characterized by alternating periods of deep breathing and apnea
Cheyne-Stokes respirations
Auscultating the heart with the bell of the stethoscope may reveal this extra heart sound directly after S2, indicating a non-compliant left ventricle and fluid overload
S3 gallop (or ventricular gallop)