OSCE

 LEFT HEART FAILURE VS RIGHT HEART FAILURE-

In heart failure, the heart can no longer pump enough blood around the body. The heart muscle is either too weak or not elastic enough.

Left-sided heart failure: The left ventricle of the heart no longer pumps enough blood around the body. As a result, blood builds up in the pulmonary veins. This causes shortness of breath, trouble breathing or coughing – especially during physical activity. Left-sided heart failure is the most common type.

Left sided heart failure occurs in people with- 

Coronary artery disease

Heart attack

High blood pressure

Valvular heart disease

Abnormal heart rhythms 

Diseases such as amyloidosis sarcoidosis

Other risk factors include- 

Diabetes

Obesity

Sleep apnea

Smoking

Toxins

Right-sided heart failure: Here the right ventricle of the heart is too weak to pump enough blood to the lungs. This causes blood to build up in the veins (the blood vessels that carry blood from the organs and tissue back to the heart). The increased pressure inside the veins can push fluid out of the veins into surrounding tissue. This leads to a build-up of fluid in the legs, or less commonly in the genital area, organs or the abdomen.

Right sided heart failure occurs in people with- 

Pulmonary embolism

Lung diseases such as chronic obstructive pulmonary disease

High blood pressure in lungs

INVESTIGATIONS-

Chest X-ray.

Electrocardiogram (EKG).

Echocardiogram.

Blood tests, especially to measure substances called natriuretic peptides (NPs).

To confirm a diagnosis of heart failure or rule out other conditions causing the symptoms, you may need:

MRI.

CT.

Cardiac catheterization.

Stress test.

Nuclear exercise stress test.

HARVARD PLATE- 

LEARNING POINTS-

 1) How to approach the patient and take detailed history and link the past history with the present illness. 

2) How diet plays an important role in the severity of the disease 

3) Importance of daily routine of the patient in identifying the etiology of the disease.