Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Symptoms ofleft-sided heart failurecan include chest pain, fatigue, shortness of breath, and leg swelling. They can be similar to other medical conditions and, early on, even go unnoticed.
When the heart has to work harder to pump blood because of a condition like heart disease, the heart weakens. This is a slow, gradual process that eventually can lead to fluid backing up into the lungs and around the heart. It’s at this point that left-sided heart failure symptoms may get worse enough to prompt you to seek medical care, if you haven’t already.
This article discusses the two types of left-sided heart failure, and what some of the symptoms are. It also looks at the causes, diagnosis, and treatment of this common heart condition.
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How Right-Sided Heart Failure Is Different
Types of Left-Sided Heart Failure
The heart has two main pumping chambers: theright ventricleand the left ventricle. The right ventricle sends blood to the lungs, where it picks up oxygen. The larger and more powerful left ventricle pumps the oxygen-rich blood to the body.
Certain medical conditions make it so your heart has to work harder to pump blood. Examples include:
Over time, this can cause the heart to weaken so it can no longer handle the blood it receives from the lungs. This is called heart failure.
Reduced function of the left ventricle is the most common cause of heart failure. There are two types of left-sided heart failure:
Systolic vs. Diastolic Heart Failure
Left-Sided Heart Failure Symptoms
You may not notice the signs of left-sided heart failure right away. Or you might attribute mild symptoms to something else, such as allergies, congestion, indigestion, or a cold.
As the heart weakens, fluid backs up into the lungs and around the heart. When this happens, your symptoms may get worse and prompt you to seek medical care.
Older adults and people with obesity may have atypical symptoms of heart failure. Any sign of chest discomfort or a rapid decline in health should always be treated as a medical emergency.
The symptoms of left-sided heart failure include:
Early diagnosis and treatment can help slow the progression of left-sided heart failure. With the right care, you can learn to manage your symptoms. If undiagnosed and untreated, however, left-sided heart failure can cause complications. These can include:
What to Know About GDMT Heart Failure Medication
Causes of Left-Sided Heart Failure
Left-sided heart failure can have many potential causes, including:
Causes and Risk Factors of Heart Failure
Systolic and diastolic heart failure can have different root causes. Systolic dysfunction (HFrEF) is often due to:
Diastolic dysfunction(HFpEF) is most often due to:
Hypertension, diabetes, obesity, smoking, and a sedentary lifestyle are preventable risk factors that you should be aware of whether you have heart failure or not.
What Is Congestive Heart Failure?
The New York Heart Association classification system is the simplest and most widely used method to gauge symptom severity among people with heart failure.
Class I
Class II
Class III
Class IV
How An Intra-Aortic Balloon Pump (IABP) Works
The diagnosis of left-sided heart failure begins with an assessment of your clinical history. Your healthcare provider will also do a physical examination and order lab work. Anechocardiogramwill help your healthcare provider assess the structure and function of your left ventricle.
An echocardiogram (or cardiac echo) is an ultrasound of the heart that can provide information on how the heart relaxes and fills with blood (diastolic function), cardiac output, and theejection fraction. The ejection fraction is a measurement of how much blood is pumped out of your heart with each beat.
Heart Failure With Preserved Ejection Fraction
To make a diagnosis of HFpEF, your healthcare provider looks for:
A diagnosis of diastolic heart dysfunction can also be measured invasively, using a catheter, or non-invasively, using doppler imaging techniques. Exercise tests can also help your healthcare provider diagnose your condition.
There are multiple conditions that can contribute to HFpEF, but the most common are:
How Heart Failure Is Diagnosed
Heart Failure With Reduced Ejection Fraction
Symptoms of HFrEF include:
Your healthcare provider will also look for evidence that your left ventricle has reduced pumping power and isn’t able to deliver as much blood as it should. This is usually seen on an echocardiogram.
With HFrEF, the left ventricular ejection fraction (LVEF) is equal to or less than 40%. This means your heart is only pumping 40% or less of the blood it contains out into the body with each beat.This is considered the diagnostic hallmark of HFrEF.
If your echocardiography is inconclusive, your healthcare provider might order more tests. These may include:
Left-sided heart failure is a progressive condition, which means it gets worse over time. It can’t be cured, but it can be managed.
In most people, heart failure is a chronic condition that requires lifelong treatment. Most treatments are geared toward slowing the progression of heart failure and managing symptoms.
Treatment of left-sided heart failure depends on the type of heart failure. There is no one-size-fits-all approach to managing the condition. The treatment should take the whole person into account, not just the heart.
A sound treatment plan usually starts with controlling your blood pressure and relieving fluid overload. Fluid overload can cause swelling or shortness of breath. Your healthcare provider will also address the anticipated mental, emotional, and physical changes that you might experience.
Research has shown that the condition can be effectively treated with a combination of drugs, which may include:
Most patients with HFrEF will benefit from being on a combination of these medications.
Jardiance, a medication used to help improve blood sugar control in those with type 2 diabetes, is also prescribed to reduce the risk of heart-related death in people with type 2 diabetes and those with heart failure and reduced ejection fraction.
Jardiance can interact with diuretics and increase the risk of dehydration, so careful monitoring and/or adjustment of other medications may be needed if Jardiance is added as part of your combination therapy.
Treating the root cause of a patient’s heart failure is the key to slowing heart disease. Here are a few examples:
Ventricular Assist Device (VAD) for Heart Failure
Heart Failure With Preserved Ejection Fraction Treatment
Diureticsare a mainstay of HFpEF treatment. For these medications to be helpful, however, you need to also make changes to your diet and overall lifestyle.
If you have HFpEF, your doctor will likely suggest you follow a treatment regimen that includes a combination of:
Diet and Lifestyle Changes
If you have heart failure, the following lifestyle changes may help you manage your symptoms:
Reducing your salt intake is especially important. Too much salt in your diet can cause fluid retention. This will counteract the drugs (diuretics) that help relieve fluid accumulation.
The best way to manage HFpEF is to treat its underlying cause, such as hypertension, diabetes, or coronary artery disease. Two medications, Entresto and SGLT2 inhibitors, have shown benefit in FHpEF.
SGLT2 inhibitor medications are antidiabetic drugs that may be used to treat HFpEF in people with or without diabetes. In people with heart failure, taking this medication can help prevent heart failure episodes. Your doctor can determine whether you are able to use an SGLT2 inhibitor.
The ACC/AHA also recommends starting or continuing a combined endurance and resistance training program for patients with HFpEF. The goal is to improve exercise capacity, physical functioning, and diastolic function. Exercise has been proven to help the heart work more efficiently.
Heart Failure With Reduced Ejection Fraction Treatment
Treatment for anyone with heart failure should start withlifestyle modification such as:
Pharmacotherapy is the cornerstone of the treatment of HFrEF. The main validated heart failure medications are:
Medications are usually added based on how effective they are at managing your symptoms. Your cardiologist will likely start with a combination of an ACE inhibitor, beta-blocker, or diuretics for symptom relief. If you are still symptomatic and your LVEF is equal to or less than 35%, an MRA might be added.
If you are still symptomatic and your LVEF is equal to or less than 35%, Corlanor orcardiac resynchronization therapymight also be considered.
Finally, if you are still symptomatic, digoxin, an LV assist device, or heart transplantation should be considered.
There is no cure for left-sided heart failure, but timely management greatly increases your chances of living well with the condition.
Left-sided heart failure, whether HFpEF or HFrEF, is a progressive condition associated with increased mortality, even if you do not have symptoms.
The prognosis of left-sided heart failure depends on many factors, including:
HFpEF Prognosis
The outlook for HFpEF is especially poor if you have been hospitalized. For people in this group, the one-year mortality rates are as high as 25% among older patients. For people over the age of 60, the five-year mortality rate is 24%. For those over the age of 80, the five-year mortality rate is 54%.
Factors associated with a worse prognosis include:
How Long Can You Live With Heart Failure?
HFrEF Prognosis
In other words, the worse the left-sided heart failure, the worse the prognosis. In one trial, 50% of participants with an ejection fraction below 15% did not live for one year.
Survival rates in patients with heart failure are 75.9% at one year, 45.5% at five years, and 24.5% at 10 years, compared to 97%, 85%, and 75% in the general population, respectively.
Despite advances in medical technology, treatment, and widespread heart health campaigns mortality rates have remained high. During the first year after diagnosis, they are 15% to 20%, and they rise to 40% to 50% within five years of diagnosis. These numbers have remained relatively consistent in recent decades.
If you are over 65 years old, you are at a particularly high risk of heart disease. This underscores the need to start a heart-healthy life sooner rather than later. Research has shown that older patients hospitalized with congestive heart failure face a grave prognosis.
After you’ve been diagnosed with heart failure, you may have feelings of fear, anger, emotional distress, and depression. The physical limitations can be tough to accept, and you may not be ready to make all the changes that are asked of you. All these reactions are natural. Talking to friends and family can help you navigate these challenges.
From adapting to taking daily medication to making adjustments to your social life, living with heart failure is not easy. The key is to make lifestyle changes that lessen the chances of havingheart failure exacerbations.
Stay in tune with your symptoms and contact a healthcare professional immediately if you sense that your condition is worsening.
Limiting stress, quitting smoking, and exercising can benefit both your physical and mental health. It’s very important to address your emotional well-being, because depression and anxiety may lead to coping strategies like drinking and eating unhealthy foods that could make things worse.
If you have the following symptoms for two or more weeks, you might be suffering from depression:
Recognizing depression is the first step to getting treatment. Talk to your healthcare provider about your options. This might include seeing a mental health provider and working through your stress with things like cognitive behavioral therapy or medication. You might also find that staying active and communicating with your loved ones about how you feel is enough to manage your mental health.
Supporting a Loved One With Heart Failure
Summary
Types of left-sided heart failure include heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. Both can cause symptoms like chest pain, fatigue, and shortness of breath.
Certain medical conditions like diabetes, high blood pressure, and coronary artery disease put you at higher risk for developing heart failure. Your healthcare provider can diagnose which type of heart failure you have based on a physical exam and tests such as an echocardiogram.
Treatment for left sided heart failure includes lifestyle changes and medications. There is no cure, but the condition can be managed.
A Word From Verywell
Learning that you have heart failure is scary. The better you understand the signs and symptoms of the condition, however, the better prepared you will be totake stepsthat can prevent exacerbations.
The once grim prognosis for heart failure can now be well managed with a combination of lifestyle modifications and medical monitoring. For example, you might start following a low-sodium diet, taking medications, and having frequent check-ins with your cardiologist.
Making many lifestyle changes in a short time can seem daunting. Leaning on your friends and family, reaching out to a mental healthcare professional, and taking part in support groups can help you cope and learn how to live with your condition.
21 Sources
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