Left ventricular failure Health Dictionary

A very fast ‘flickering’ of the heart with no measurable circulation of blood by the heart. This usually occurs after a heart attack (or electrocution).... ventricular fibrillation

An inherited defect of the HEART. The septum (partition) separating the two ventricles is pierced by a hole which, if large, results in blood being diverted to the LUNGS at a greater pressure than normal. This may lead to irreversible PULMONARY HYPERTENSION, which early surgical intervention (repair of the septal defect) should prevent. A quarter of patients with VSD have other cardiac defects. Half of the defects seal themselves spontaneously.... ventricular septal defect

Failure of expected growth in an infant or toddler, usually assessed by comparing the rate at which a baby gains weight with a standardized growth chart. An undiagnosed illness such as a urinary infection may be the cause. Emotional or physical deprivation can also cause failure to thrive. A child who fails to grow at the appropriate rate needs tests to determine the cause.... failure to thrive

Inability of the heart to cope with its workload of pumping blood to the lungs and to the rest of the body. Heart failure can primarily affect the right or the left side of the heart, although it most commonly affects both sides, in which case it is known as congestive, or chronic, heart failure.

Left-sided heart failure may be caused by hypertension, anaemia, hyperthyroidism, a heart valve defect (such as aortic stenosis, aortic incompetence, or mitral incompetence), or a congenital heart defect (see heart disease, congenital). Other causes of left-sided heart failure include coronary artery disease, myocardial infarction, cardiac arrhythmias, and cardiomyopathy.

The left side of the heart fails to empty completely with each contraction, or has difficulty in accepting blood that has been returned from the lungs. The retained blood creates a back pressure that causes the lungs to become congested with blood. This condition leads to pulmonary oedema.

Right-sided heart failure most often results from pulmonary hypertension, which is itself caused by left-sided failure or by lung disease (such as chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). Right-sided failure can also be due to a valve defect, such as tricuspid incompetence, or a congenital heart defect.

There is back pressure in the circulation from the heart into the venous system, causing swollen neck veins, enlargement of the liver, and oedema, especially of the legs and ankles. The intestines may become congested, causing discomfort.

Immediate treatment consists of bed rest, with the patient sitting up. Diuretic drugs are given, and digitalis drugs and vasodilators, especially ACE inhibitors, may also be administered. Morphine and oxygen may be given as emergency treatment in acute left-sided failure.... heart failure

A serious cardiac arrhythmia in which each heartbeat is initiated from electrical activity in the ventricles rather than from the sinoatrial node in the right atrium.

It is caused by an abnormally fast heart-rate due to serious heart disease, such as myocardial infarction or cardiomyopathy.

It may last for a few seconds or for several days.

Diagnosis is confirmed by ECG.

Emergency treatment is with defibrillation and an antiarrhythmic drug.... ventricular tachycardia

A term used when a hole in the septum (internal wall) of the HEART allows blood to ?ow from the systemic circulation properly con?ned to the left side of the heart to the pulmonary circulation, con?ned to the right. The shunt is usually detected by hearing a murmur, and the diagnosis con?rmed by ECHOCARDIOGRAPHY (see also SEPTAL DEFECT).... left to right shunt

Inefficient functioning of the kidney, leading to death unless acute medical attention is available. Envenomation (especially snake bite) is a common cause, as well as a range of medical conditions, including infection..... renal failure (acute)

Enlargement of the ventricular chambers of the HEART, a common complication of HYPERTENSION and coronary artery disease (see HEART, DISEASES OF). Treatment is of the underlying conditions and cardiac drugs which facilitate the working of the heart.... ventricular hypertrophy

Failure of the left ventricle to receive blood from the pulmonary circulation and to maintain efficient output of incoming blood to the arterial system. Failure to do so leads to congestion of blood in the lungs followed by fluid retention. If uncorrected, leads to kidney disturbance, low blood pressure, cyanosis (blueness of the skin). Onset may be tragically sudden.

Failure of the left ventricle may occur in cases of pericarditis, disease of the aortic valve, nephritis or high blood pressure.

Left ventricular failure is often of sudden onset, urgent, and may manifest as “cardiac asthma”.

Causes: blood clot, anaemia, thyroid disorder, coronary disease, congenital effects, drug therapy (beta blockers, etc), and to fevers that make heavy demands on the left ventricle.

Symptoms: breathlessness, wheezing, sweating, unproductive cough, faintness, bleeding from the lungs, palpitation. Cardiac asthma at night: feels he needs air; better upright than lying flat. Exertion soon tires. Sensation as if heart would stop. Blueness of lips and ears from hold-up in circulation of the blood through the lungs. Frequent chest colds. Awakes gasping for breath. Always tired. Cold hands and feet. Symptoms abate as compensation takes place. ‘Cream and roses’ complexion. The failure of left ventricle soon drags into failure of the right ventricle.

Right ventricular failure leads to congestive heart failure, with raised venous pressure in neck veins and body generally, causing oedema, ascites and liver engorgement.

Treatment. Agents to strengthen, support, and eliminate excess fluids from the body. BHP (1983) advises four main remedies: Hawthorn, Motherwort, Broom and Lily of the Valley. The latter works in a digitaloid manner, strengthening the heart, contracting the vessels, and lessening congestion in the lungs. Tinctures. Hawthorn 2; Stone root 1. Lily of the Valley 1. Dose: 15-45 drops thrice daily.

Broom tea. 2 teaspoons flowers, or 2-3 teaspoons tops and flowers, in cup water brought to boil and simmered one minute. 1 cup freely.

To remove fluid retention in the lungs, diuretics are indicated; chief among which is Dandelion root because of its high potassium content to prevent hypokalaemia. Dandelion coffee. As urinary excretion increases, patient improves.

Vitamin E. Not to be taken in left ventricular disorders.

Diet. See entry: DIET – HEART AND CIRCULATION.

UK Research. Researchers found that left ventricular failure was reduced by a quarter when patients were given magnesium intravenously for the first 24 hours after admission to the coronary care unit. They conclude that it should be given before any other heart therapy is commenced, and that patients should receive regular infusions if no other drug treatment is used. (The Lancet, 2.4.1994). This supports the use of magnesium sulphate (Epsom’s salts) by a past generation of herbal practitioners for the condition. ... heart – left ventricular failure (lvf)

Insufficient production of hormones by the adrenal cortex (the outer part of the adrenal glands).

It can be acute or chronic.

Adrenal failure may be caused by a disorder of the adrenal glands, in which case it is called Addison’s disease, or by reduced stimulation of the adrenal cortex by ACTH, a hormone produced by the pituitary gland.... adrenal failure

See brain syndrome, organic.... brain failure

See heart failure.... congestive heart failure

See kidney failure.... renal failure

A condition in which there is a buildup of carbon dioxide and a fall in the level of oxygen in the blood (see hypoxia). Causes include lung disorders, such as severe asthma, emphysema, or chronic bronchitis (see pulmonary disease, chronic obstructive), or damage to the respiratory centre in the brain due to, for example, an overdose of opioid drugs, a stroke, or serious head injury.

Treatment is with ventilation and oxygen for the underlying cause.... respiratory failure

Failure of the right ventricle to hold its own with the return flow of blood and to re-direct it through the lungs where it is re-oxygenated before entering the left ventricle for completing the circulatory cycle. Usually secondary to failure of the left ventricle. May be caused by valvular disease, especially narrowing of the orifice of the mitral valve.

Mitral disease leads to heart failure either by a narrowing of the orifice (stenosis) or a regurgitation blocks the passage of blood from the left atrium (auricle) to the left ventricle. The left atrium enlarges (hypertrophies) in an effort to counter the impediment. Real compensation – increased thrust of the blood – is provided by the right ventricle. In order to overcome a mitral impediment the right ventricle has to enlarge.

Sooner or later the right ventricle cannot enlarge any further and general heart failure sets in. Though caused primarily by a lesion of the mitral valve, it may be secondary to left ventricular failure (LVF), thyroid disorder (thyrotoxicosis), pericarditis, congenital heart disease, or any disease which weakens ventricular muscle.

Venous congestion and back pressure of RVF leads to congestion and accumulation of fluid in the lungs, cough and spitting of blood, painful swelling of the liver, nausea, loss of appetite and severe wasting.

Where the right ventricle fails to move the blood forward as it arrives from the systemic circulation, generalised dropsy sets in. Congestion of the kidneys leads to reduced urinary excretion and presence of albumin in the urine.

The picture is well known to the cardiac practitioner: blueness of the skin, congestion of the brain circulation with sleeplessness and delirium. Soon the tension of water-logged tissues results in pain and extreme anxiety. Feet are swollen and ankles pit on pressure; chest cavities fill with fluid and the abdomen swells (ascites).

Alternatives. Cardio-tonics would be given to strengthen the ventricle and diuretics to correct fluid retention: Lily of the Valley, Hawthorn, Motherwort, Broom. BHP (1983).

Due to rheumatic fever: Hawthorn.

High Blood Pressure: Mistletoe.

Effort Syndrome: Motherwort.

Tinctures. Combine, Lily of the Valley 2; Hawthorn 2; Motherwort 3. Dose: 1 teaspoon thrice daily after meals.

Diet. Low salt, low fat, high fibre. Restricted fluids, vegetarian protein foods, yoghurt. See also: DIET – HEART AND CIRCULATION.

Supplements. Potassium (bananas), Vitamin B6.

General. Stop smoking. Correction of overweight. Complete bed-rest with legs raised above level of the abdomen and patient propped-up to relieve difficult breathing. ... heart – right ventricular failure (rvf)

A very serious form of congenital heart disease (see heart disease, congenital). The baby is born with a poorly formed left ventricle, often associated with other heart defects. The aorta is malformed and blood can reach it only via a duct (the ductus arteriosus) that links the aorta to the pulmonary artery.

At birth, the baby may seem healthy. However, within a day or 2 the ductus arteriosus naturally closes off and the baby collapses, becoming pale and breathless. In most cases, hypoplastic left-heart syndrome cannot be treated surgically, and most affected babies die within a week. A few infants have been treated with heart transplants.... hypoplastic left-heart syndrome

A life-threatening condition in which the amount of carbon dioxide in the blood rises, and the amount of oxygen falls, due to disruption of the normal exchange of gases between the air in the lungs and the blood. Ventilatory failure may be due to brain damage or to depression of the respiratory centres by excessive doses of drugs such as morphine. Treatment may involve artificial ventilation or, in some cases, the use of respiratory stimulant drugs. (See also respiratory failure.)... ventilatory failure

A type of cardiac arrhythmia in which abnormal heartbeats are initiated from electrical impulses in the ventricles of the heart. In a normal heart, beats are initiated by the sinoatrial node in the right atrium.

Ventricular ectopic beats may be detected on an ECG.

If there are frequent abnormal beats that cause symptoms, or beats that arise from more than 1 site in the ventricles, treatment with an antiarrhythmic drug may be required.... ventricular ectopic beat

Severe impairment of liver function that develops suddenly or at the final stages of a chronic liver disease. Because the liver breaks down toxins in the blood, liver failure causes the levels of the toxins to rise, affecting the functioning of other organs, particularly the brain. Liver failure may be acute or chronic. Symptoms of acute liver failure develop rapidly and include impaired memory, agitation, and confusion, followed by drowsiness. The functioning of other organs may become impaired, and the condition may lead to coma and death. Features of chronic liver failure develop much more gradually and include jaundice, itching, easy bruising and bleeding, a swollen abdomen due to accumulated fluid, red palms and, in males, gynaecomastia (enlarged breasts) and shrunken testes. Chronic liver failure may suddenly deteriorate into acute liver failure.

Acute liver failure requires urgent hospital care.

Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.

Consumption of alcohol should cease in all cases.

The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.

For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure

acute kidney injury (see AKI).... acute renal failure

(ARF) a primary disorder of gaseous exchange (as distinct from failure of the mechanical process of breathing). The prototype of ARF is *adult respiratory distress syndrome, but the term sometimes also refers to disruption of any other part of the respiratory system, including the respiratory control centre in the brain with its *efferent and *afferent pathways.... acute respiratory failure

(CCF, congestive heart failure) see heart failure.... congestive cardiac failure

(ESRF, CKD 5) the most advanced stage of kidney failure, which is reached when the *glomerular filtration rate (GFR) falls to 15 ml/min (normal GFR = 100 ml/min).... end-stage renal failure

a congenital heart disorder in which the left side of the heart, particularly the left ventricle, is underdeveloped. The first part of the aorta may also be abnormal. Affected babies usually develop severe heart failure within the first few days of life. Diagnosis can be confirmed on *echocardiography. Prognosis is generally very poor – most babies die within the first few weeks – but milder cases may be amenable to surgery. It is the commonest cause of death in the neonatal period due to heart disease.... hypoplastic left heart

(MOF) see multiple organ dysfunction syndrome.... multi-organ failure

acute kidney injury caused by myoglobin that is released from damaged skeletal muscle (*rhabdomyolysis). This is usually the result of trauma and the condition was first recognized in victims trapped and crushed during the London Blitz. Muscle injury can also occur with pressure necrosis, particularly in the unconscious or immobile patient, or with a *compartment syndrome. Rarely it may complicate intensive muscular exercise or extensive viral myositis and it is a recognized complication of modest overexertion in some inherited disorders of muscle metabolism, such as *McArdle’s disease.... myoglobinuric acute renal failure

menopause occurring before the age of 40. It may be caused by autoimmunity, chemotherapy, radiotherapy, or genetic factors, for example a mutation in the FSH receptor gene causing excess secretion of gonadotrophins and small underdeveloped ovaries. Treatment is by hormone replacement, either with the contraceptive pill or HRT. *Oocyte donation should be discussed if the patient wishes for assisted conception.... premature ovarian failure

(VAD) a mechanical pump implanted in the body for the purpose of taking over some or all of the pumping action of the heart in patients with severe heart damage. Support may be given to the left ventricle (LVAD), right ventricle (RVAD), or both. Most such devices require *thoracotomy, but a percutaneous device is now also available. This is usually regarded as a temporary measure until the heart has recovered or is transplanted.... ventricular assist device

see vocal folds.... ventricular folds