Left-Sided Heart Failure vs Right-Sided Heart Failure Pathophysiology Nursing NCLEX Review

Summary

In this educational video, Sarah, a registered nurse, explains the differences between left-sided and right-sided heart failure. She describes the heart's anatomy, the causes, and symptoms of each type, using mnemonics to aid memorization. Right-sided failure presents with peripheral swelling, while left-sided failure leads to pulmonary issues. Sarah emphasizes the importance of monitoring ejection fraction and daily weights to assess heart failure severity and progression.

Takeaways

• 🧡 The heart has two sides with different functions: the left side is connected to the lungs (pulmonary circulation), and the right side is connected to the venous circulation.
• 💔 Heart failure occurs when the heart becomes too weak to pump blood effectively, leading to fluid volume overload and congestion.
• 📈 Right-sided heart failure is characterized by peripheral signs like swelling in the legs, feet, abdomen (ascites), and jugular venous distention (JVD).
• 🔁 Right-sided heart failure is often a result of left-sided heart failure, with fluid pressure backing up from the left to the right side, causing overwork.
• 📊 Signs and symptoms of right-sided heart failure can be remembered with the word 'swelling': swelling in legs, feet, abdomen, weight gain, edema, large neck veins, lethargy, irregular heartbeat, nausea, and increased abdominal girth.
• 🚫 Left-sided heart failure involves the left ventricle's inability to pump oxygenated blood into the arterial circulation, leading to pulmonary congestion.
• 🔍 Left-sided heart failure can be categorized into systolic (reduced ejection fraction) or diastolic (preserved ejection fraction) dysfunction.
• 🩺 Ejection fraction (EF) measures the heart's pumping efficiency, with a normal EF being 50 or greater and an EF of 40 or less indicating heart failure.
• 🌊 Signs of left-sided heart failure include pulmonary symptoms like difficulty breathing, crackles (abnormal sounds indicating pulmonary edema), orthopnea, weakness, nocturnal paroxysmal dyspnea, increased heart rate, nagging cough, and weight gain.
• 🛑 A nagging cough can be an early sign of heart failure and should be reported for medical attention to prevent complications like cardiogenic shock.
• 📈 Monitoring daily weights is crucial for patients with heart failure as rapid weight gain can indicate fluid retention and worsening heart failure.

Q & A

What is the primary function of the heart's left side?

The left side of the heart is responsible for pumping oxygenated blood into the arterial circulation, which then distributes it throughout the body.

What is the connection between the right side of the heart and the body's circulation system?

The right side of the heart receives deoxygenated blood from the venous system and pumps it to the lungs for re-oxygenation via the pulmonary circulation.

What happens in right-sided heart failure?

In right-sided heart failure, the right side of the heart is unable to effectively pump blood, leading to blood congestion in the venous system, increased pressure in the vena cava, and symptoms like hepatomegaly, jugular venous distention (JVD), and peripheral edema.

What causes right-sided heart failure?

Right-sided heart failure is often a result of left-sided heart failure, where increased fluid pressure backs up from the left side to the right, causing the right side of the heart to become overworked.

What mnemonic can be used to remember the signs and symptoms of right-sided heart failure?

The mnemonic 'SWELLING' can be used, where S stands for swelling in the legs, feet, and abdomen (ascites), W for weight gain, E for edema, L for large neck veins (JVD), L for lethargic, I for irregular heartbeat, N for nausea, and G for increased girth of the abdomen.

What is the difference between systolic and diastolic heart failure in the context of left-sided heart failure?

Systolic heart failure, indicated by a reduced ejection fraction, involves the left ventricle's inability to effectively eject blood, while diastolic heart failure, with a preserved ejection fraction, involves the ventricle being too stiff to allow for normal filling of blood.

What is an ejection fraction and why is it important in diagnosing heart failure?

Ejection fraction is a measurement used to determine the severity of heart failure, representing the percentage of blood that the ventricles pump out with each contraction. A normal ejection fraction is 50 or greater, while an EF of 40 or less indicates heart failure.

What mnemonic can be used to remember the signs and symptoms of left-sided heart failure?

The mnemonic 'DROWNING' can be used, where D stands for difficulty breathing, R for rales (crackles), O for orthopnea, W for weakness, N for nocturnal paroxysmal dyspnea, I for increased heart rate, N for nagging cough, and G for gaining weight.

Why is monitoring a patient's weight important in managing heart failure?

Monitoring a patient's weight is crucial because unexplained weight gain can be an early indicator of fluid retention and potential worsening of heart failure.

What is cardiogenic shock and how can it be related to untreated heart failure?

Cardiogenic shock is a severe condition where the heart fails to pump enough blood to meet the body's needs. Untreated heart failure can lead to the heart becoming completely overwhelmed, potentially resulting in cardiogenic shock.