1. General considerations
2. Symptoms: RHF, LHF
3. Causes: RHF, LHF

General considerations

For RHF and LHF, when a side of the heart fails, things behind it in the circuit will build up. Lungs are behind left heart, so in LHF get pulmonary edema. Systemic circulation is behind right heart, so in RHF, get peripheral edema.

Symptoms: RHF

• Distended neck veins, raised JVP.
• Nutmeg liver.
• Enlarged, congested spleen.
• Congested kidneys.
• Pitting, ankle edema.
• Ascites.

Symptoms: LHF

• Pulmonary edema.
• Cyanosis.
• Dyspnea.
• Paroxysmal nocturnal dyspnea.
• Cough.
• Frothy sputum.
• Fatigue.
• Tachycardia.
• S3.
• Pulsus alterans.
• Systemic hypofusion:
  • Kidneys underperfused.
  • Muscles underperfused, so weak.
  • Brain underperfused, so confusion in elderly.

Causes: RHF

• LHF.
• COPD [called "cor pulmonale"].
• Tricuspid regurgitation.

Causes: LHF

• Hypertension.
• CAD.
• MI.
• Mitral valve incompetence.
• Aortic valve incompetence.