Left Ventricular Failure
It is a condition characterized by a failure of function of the left ventricle due to chronic strain.
Aetiology
1.Ischemic
heart disease.
2.Myocarditis.
3.Hypertension.
4.Aortic
stenosis.
5.Mitral
stenosis.
6.Ventricular
septal defect.
7.Aortic
stenosis and mitral regurgitation.
Clinical Features
1.Dyspnoea
on minimal activity.
2.Orthopnoea:The
patient cannot lie down due to breathlessness, which is relieved only on sitting
up.
3.Paroxysmal
nocturnal dyspnoea: The patient gets breathless during sleep and sits up. Then
he feels better. This is also known as cardiac asthma. Such a patient also has
the following features:
.Excessive sweating.
.Cyanosis
.Cold skin.
.Stridor.
4.Cough
with expectoration due to pulmonary congestion.
5.Repeated
upper respiratory tract infections.
6.Haemoptysis.
7.Weakness,lethargy,tiredness.
8.Nocturnal
frequency off micturition, and oliguria during the day time.
9.Pulse
rate is increased and the pulse is irregular.
10.Chest
X-ray shows left ventricular enlargement.
11.The
following features of congestive cardiac failure are absent.
.Elevation of jugular venous pressure.
.Oedema.
Investigations
1.ECG.
2.Chest
X-ray.
3.Investigations
for the cause of the left ventricular failure.
Treatment
1.Complete
bed rest on a cardiac bed in reclining
position.
2.Morphine
15 mg or pethidine 50 mg IM.
3.Oxygen.
4.Furosemide
40 mg to 60 mg IV.
5.Aminophyline
250 mg to 500 mg mixed with dextrose IV
slowly.
6.Digitalization.
7.Antihyprtensive
drugs if the patient is hypertensive.
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