Jorgio has just found out there is also right-sided and left-sided heart failure. He wants to know what the difference is and how it affects the rest of the body. Compare and contrast right-sided and left-sided heart failure
a. What causes left-sided versus right-sided failure?
b. Describe the treatment for both types. Are they similar?
c. Which of the two progresses to a more severe prognosis?
d. What are the symptoms?
e. Does either have compensatory mechanisms?
Students' answers should include the following:
a. Pathophysiology and etiology of both right-sided and left-sided heart failure depends on which side of the heart is affected or damaged and can no longer pump effectively.
Left-sided heart failure is due to impairment of the left ventricle's ability to eject blood into the aorta.
Right-sided heart failure is due to the right ventricle failing to eject the total diastolic filling volume into the pulmonary artery, resulting in congestion of the venous vascular system.
Right-sided failure can cause cardiomegaly or hypertension, causing the ventricles to not have enough blood to pump out.
b. Treatment is aimed at increasing cardiac output, decreasing fluid accumulation, low-sodium diet, increasing afterload, and decreasing preload. Treatment is basically the same or similar for both left-sided and right-sided failure.
c. Right-sided failure is more severe; clients with MIs and chronic respiratory disorders tend to develop right-sided failure.
d. Impaired gas exchange, blood pooling, hypoxia, hypertension, and valvular disease; kidney failure, can lead to chronic failure.
Fluid retention, hemoptysis, and paroxysmal nocturnal dyspnea.
Preload and afterload are affected; fluid is accumulated.
Respiratory disorders and cor pulmonale affect right-sided failure.
Right ventricle enlargement and increased workload, leading to failure
e. Compensation is done by increasing stroke volume and maintaining blood pressure until contractility is further compromised. Eventually, compensation no longer works.
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