Left Ventricular Dysfunction

ExitCare ImageLeft ventricular dysfunction means that the main pumping chamber of your heart (left ventricle) is not working well. The heart is a muscle and needs a constant supply of oxygen and blood. If the arteries that deliver the oxygen and blood are blocked, parts of the heart may get weak and not pump well. The heart may also get weak from having to constantly pump against the resistance of high blood pressure or narrow arteries.

CAUSES

  • Damage after a heart attack.

  • High blood pressure.

  • Leaking or malfunctioning heart valves.

  • Toxins such as alcohol.

  • Metabolic problems such as:

  • Vitamin deficiencies.

  • Thyroid problems.

  • Diabetes.

Heartbeats that are irregular or too fast for a long time.

SYMPTOMS

Symptoms may progress to include:

  • Fatigue.

  • Reduced ability to exercise.

  • Trouble breathing, especially when active.

  • Shortness of breath at rest.

  • Trouble breathing when lying down at night.

  • Being more tired, lightheaded, or confused.

  • Weight gain with swelling of the legs and feet.

  • Passing out.

  • Sudden cardiac death.

DIAGNOSIS

Your doctor may find that your heart pumping function is reduced after taking a medical history and doing a physical exam.

  • Clues from your exam may include:

  • The veins in your neck are too big.

  • An irregular heart beat.

  • Abnormal heart sounds

  • Sounds in your chest from fluid in your lungs.

  • Swelling in your ankles or feet.

  • Tender places in your belly plus swelling.

  • Other studies that may be done include:

  • Chest x-ray

  • EKG (a recording of the electrical activity of your heart).

  • Echocardiogram (a picture of your heart made by using sound waves).

  • Holter monitoring (portable longer term checking of your heart rhythm).

  • Cardiac stress testing to see how well your heart is pumping.

  • Angiogram to look for any blocked arteries.

HOME CARE INSTRUCTIONS

  • Activity Level--- Your caregiver will help you determine what type of exercise program may be helpful. It is important to maintain strength and increase it if possible. Pace your activities and avoid shortness of breath or chest pain. Plan activities for at least an hour after meals or before eating. This allows your body to handle one activity at a time. Your caregiver can help advise you.

  • Diet--- Maintain a low salt and heart healthy diet,or as directed by your caregiver. Get diet information from your caregiver or a registered dietician. Keep your salt shaker out of sight and avoid adding salt to your foods. Measure the amounts of fluids you take in per day in cups and record these amounts.

  • Medications--- You may have been prescribed an ACE Inhibitor or a beta blocker to take for your heart failure. Take these medications as directed. They improve your heart function and your survival. Ask your caregiver if taking statins (drugs to lower cholesterol) would be helpful. Diuretics or water pills may be prescribed to help get rid of fluids. You may also be given a potassium supplement to replace the amount lost from the water pills.

  • Weight Monitoring---Record your hospital or clinic weight. When you get home, compare it to your scale and record your weight. Weigh twice per day at first and record these weights. Try to weigh at the same time every day. It is best to weigh first thing in the morning, in your same clothes, after going to the bathroom and before eating or drinking anything. Place the scale on a hard surfaced floor. Bring these weights to your caregiver to be reviewed during your appointments.

  • Blood pressure monitoring should be done twice a day at first, morning and evening when you are relaxed. Once your blood pressure has stabilized, rechecking once a day and then a few times a week may be enough. You can get a home blood pressure cuff at your drugstore. Record these values and bring them with you for your clinic visits. Notify your caregiver if you become dizzy or lightheaded upon standing up.

  • Be familiar with your medications--- If you have trouble remembering when you took them, write down times or set your medications out in advance for the day or the week to avoid problems. If you take your medications twice a day, place them by your toothbrush and get in the habit of brushing your teeth twice a day. If you are on a water pill (diuretic), take these in the morning so you are not up all night going to the bathroom.

  • If you are currently a smoker, it is time to quit. Nicotine makes your heart work harder and is one of the leading causes of cardiac (heart) deaths. Do not leave your doctor's office without a smoking cessation plan or instructions on help available to quit smoking.

  • Immunization with influenza and pneumococcal vaccines may reduce the risk of respiratory infection.

  • Nonsteroidal anti-inflammatory drugs should not be used. They can cause salt (sodium) retention and also may impair the action of diuretics and ACE inhibitors. They can also elevate blood pressure. This includes drugs such as Advil, Motrin, ibuprofen, etc.

  • Aldosterone Antagonists such as spironolactone may have helpful effects and may be used if there are symptoms at rest despite the use of diurectics, an ACE inhibitor and (usually) a beta-blocker. Aldosterone antagonism is recommended in advanced heart failure in addition to ACE inhibition and diuretics to improve survival and decrease chances of other problems.

  • If you do not follow your diet and take your medications properly, this may lead to a rapid decline in your health, emergency care or hospitalization. Follow the advice of your caregiver.

  • What To Do If Symptoms Worsen--- If there are immediate problems go to the Emergency Department. This would include any symptoms which brought you in and which are getting worse rather than better. Call your local emergency services (911 in U.S.) for immediate care.

DAILY PATH TO QUALITY LIVING

  • Monitor weight and record.

  • Monitor blood pressure and record.

  • Monitor fluid intake.

  • Monitor sodium intake.

  • Monitor activity levels.

  • Take your medications.

  • Stop all use of nicotine.

  • Know when to call for help and do so.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your weight increases by 03 lb/1.4 kg in 1 day or 05 lb/2.3 kg in a week, or as your caregiver suggests.

  • You notice increasing shortness of breath during rest, sleeping, or with activity, and which is unusual for you.

  • You develop an increase in angina, or develop chest pain which is unusual for you.

  • You develop sweating or nausea which is unusual for you.

  • You notice swelling in your hands, feet, ankles or abdomen.

  • You have a feeling of fullness in your abdomen or develop nausea or loss of appetite.

  • You notice lasting (persistent) dizziness, blurred vision, headache, or unsteadiness.

Make an appointment with your caregiver as directed for follow-up.