The various types and their description of Heart failure are as follows:
Left Sided Versus Right Sided Heart Failure
Predominantly left sided failure is seen in left ventricular infarction, hypertension, aortic and mitral valve diseases. The symptoms are due to pulmonary congestion (backward failure) and manifest as various degrees of dyspnoea to acute pulmonary edema. Fatigue, muscle weakness and mental confusion may also be seen as a result of forward failure.
The commonest cause of right-sided failure is left-sided failure, but is also seen in pulmonary hypertension due to other causes. Raised jugular venous pressure, hepatic congestion and edema are classical features of right-sided failure.
Acute Versus Chronic Heart Failure
When the syndrome sets in at a rapid rate before the compensatory mechanisms become operative, acute heart failure develops. The examples are acute heart failure due to acute myocardial infarction, tachyarrhythmias, acute mitral regurgitation and rupture of sinus of Valsalva aneurysm.
If the anatomical abnormalities progress gradually and there is sufficient time for the adaptive mechanisms to develop, chronic heart failure sets in.
Left Sided Versus Right Sided Heart Failure
Predominantly left sided failure is seen in left ventricular infarction, hypertension, aortic and mitral valve diseases. The symptoms are due to pulmonary congestion (backward failure) and manifest as various degrees of dyspnoea to acute pulmonary edema. Fatigue, muscle weakness and mental confusion may also be seen as a result of forward failure.
The commonest cause of right-sided failure is left-sided failure, but is also seen in pulmonary hypertension due to other causes. Raised jugular venous pressure, hepatic congestion and edema are classical features of right-sided failure.
Acute Versus Chronic Heart Failure
When the syndrome sets in at a rapid rate before the compensatory mechanisms become operative, acute heart failure develops. The examples are acute heart failure due to acute myocardial infarction, tachyarrhythmias, acute mitral regurgitation and rupture of sinus of Valsalva aneurysm.
If the anatomical abnormalities progress gradually and there is sufficient time for the adaptive mechanisms to develop, chronic heart failure sets in.
Low Output Versus High Output Heart Failure
Most forms of cardiac diseases, like hypertension, valvular diseases and coronary artery diseases manifest as low output heart failure. Systemic vasoconstriction with cold extremities is a feature.
High cardiac output failure is seen in thyrotoxicosis, beriberi, arterio-venous fistula and anemia.Warm extremities and wide pulse pressure are the features.
Systolic Versus Diastolic Failure
Systolic heart failure is a classic heart failure where the inotropic (contractile) state is impaired and the expulsion of blood is not adequate. So the main manifestations of systolic failure are due to inadequate cardiac output and fluid retention.Diastolic failure has been a less familiar entity so far and is due to a defect in ventricular filling.The ability of ventricles to accept blood is impaired. In this, there is incomplete ventricular relaxation, transiently as in myocardial ischemia, or in a sustained form as in restrictive cardiomyopathy. The major manifestations are due to elevated ventricular filling pressures,leading to pulmonary or systemic venous congestion in the presence of preserved left ventricular systolic function (i.e. normal left ventricular ejection fraction and end-diastolic volume).
High cardiac output failure is seen in thyrotoxicosis, beriberi, arterio-venous fistula and anemia.Warm extremities and wide pulse pressure are the features.
Systolic Versus Diastolic Failure
Systolic heart failure is a classic heart failure where the inotropic (contractile) state is impaired and the expulsion of blood is not adequate. So the main manifestations of systolic failure are due to inadequate cardiac output and fluid retention.Diastolic failure has been a less familiar entity so far and is due to a defect in ventricular filling.The ability of ventricles to accept blood is impaired. In this, there is incomplete ventricular relaxation, transiently as in myocardial ischemia, or in a sustained form as in restrictive cardiomyopathy. The major manifestations are due to elevated ventricular filling pressures,leading to pulmonary or systemic venous congestion in the presence of preserved left ventricular systolic function (i.e. normal left ventricular ejection fraction and end-diastolic volume).
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