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Heart, section through the middle
Heart, section through the middle
Heart, front view
Heart, front view

Left-sided heart failure
Definition:
Left-sided heart failure is a disorder in which the left side of the heart loses its ability to pump blood efficiently, thereby failing to meet the demands of the body.

Alternative Names:
Congestive heart failure - left

Causes, incidence, and risk factors:

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 of left-sided failure include the following:

In children, common causes include heart birth defects such as abnormal heart valves, abnormal blood vessel connections, or viral infections.

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

Physical examination may reveal an irregular or rapid heartbeat and increased rate of breathing. Listening to the heart may reveal heart murmurs or extra heart sounds, and listening to the lungs may reveal crackles or decreased breath sounds at the bottom. The skin of the legs may have excessive fluid and may remain dimpled when pressed.

Tests may include the following:
Treatment:

The goals of treatment include treating the underlying disease, relieving stress on the heart and minimizing symptoms and risks of worsening heart failure.

  • Consultation with a heart specialist is recommended.
  • Hospitalization may be required when symptoms are severe.
  • Treatment of underlying disease may include opening blocked heart arteries by either cardiac catheterization or bypass surgery, treatment of high blood pressure, or avoidance of heart toxins such as alcohol.
  • Decreasing salt intake, avoiding alcohol and doing moderate exercise as tolerated are recommended.
  • Diuretics (medication to accelerate removal of body water) such as lasix or aldactone are given to treat fluid retention
  • Medications to decrease heart stress, such as beta blockers and ACE inhibitors, are also given. These medications also prevent further muscle damage and scarring, especially when the heart muscle is weak.
  • Digoxin may be given to increase muscle strength and slow down abnormally fast heart rates.

In severe cases, IV medications are given to promote water removal and to increase heart pumping function

In very severe cases in which medicines alone are not sufficient, mechanical devices to assist the left heart in pumping blood can be implanted. Heart transplantation may need to be performed based upon availability of a donor heart.
Expectations (prognosis):
Heart failure is a serious disorder that carries a possibility of reduced life expectancy. Prognosis depends upon the underlying disorder, age, and tolerated level of activity of the patient. In many cases, there is little chance for full recovery of heart function. However, many forms of heart failure are well controlled with medication and can remain stable for many years with occasional exacerbations of symptoms.
Complications:

Calling your health care provider:
Call your health care provider if symptoms indicating congestive heart failure occur.

Call your health care provider or get to the emergency room if symptoms are severe or if you experience chest pain, weakness, fainting, rapid or irregular heartbeat, increased cough or sputum production, sudden weight gain, or swelling.

Call your baby's health care provider if the infant has weight loss, poor feeding, or does not appear to be growing or developing normally.
Prevention:
Follow your health care provider's advice for treatment of conditions that may cause congestive heart failure. Follow dietary guidelines and minimize or eliminate smoking and alcohol consumption.
Review Date: 7/28/2002
Reviewed By: Steven Kang, M.D., Division of Cardiology, Harbor-UCLA Medical Center, Torrance, CA. Review provided by VeriMed Healthcare Network.
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