Difference Between Right Sided and Left Sided Heart Failure

Key Difference – Right Sided vs Left Sided Heart Failure

Cardiac diseases have been topping the list of killer diseases for the last 2-3 decades thanks to the stressful and unhealthy lifestyle we have got used to. Heart failure is the inability of the heart to pump blood adequately to fulfill the demand of the body.When this inability is due to the impairment of the functional capacity of theright cardiac chambers，我们称其为正确的心力衰竭。On the other hand,if the heart failure is due to the incompetence of the left cardiac chambers that is called a left heart failure。这是右侧和左侧心力衰竭之间的区别。

CONTENTS

1.Overview and Key Difference
2.What is a Right Sided Heart Failure
3.What is a Left Sided Heart Failure
4.Similarities Between Right Sided and Left Sided Heart Failure
5.Side by Side Comparison – Right Sided vs Left Sided Heart Failure in Tabular Form
6.Summary

什么是右侧心力衰竭？

When the heart fails to pump blood adequately to the body tissues owing to the decrease in the pumping capacity of the right heart chambers, that condition is identified as the right heart failure.

右侧心力衰竭发生在大多数情况下是左侧心力衰竭的继发性。当心脏的左侧，特别是left ventricle, fails to pump blood sufficiently into the aorta, blood starts to pool inside the left heart chambers. Consequently the pressure inside these chambers increases. This impairs the drainage of blood into the leftatrium从肺通过肺静脉。As a result, the pressure inside the pulmonary vasculature also rises. Therefore, the right ventricle has to contract more vigorously against a higher resistive pressure to pump blood into the lungs. With the long-term prevalence of this condition, heart muscles of the right chambers start to wear down ultimately resulting in the right sided heart failure.

尽管不经常看到，但右侧心力衰竭也可能是由不同的内在肺病理（例如COPD,bronchiectasis和肺血栓栓塞。

效果

• Edema在身体的依赖区域，例如脚踝。在更高级的阶段，患者还可以获得腹水和胸腔积液。
• 充血有机肿大，例如肝肿大。

What is Left Sided Heart Failure?

心脏无法充分满足人体的代谢需求，被称为心力衰竭。当这种故障是由于左心腔的抽水能力步履蹒跚时，这被称为左侧心力衰竭。

Causes

• Ischemic heart diseases
• Hypertension
• 主动脉和二尖瓣疾病
• 其他心肌疾病，例如myocarditis

Left sided heart failure is accompanied by certain morphological changes in the heart. The left ventricle undergoes compensatory hypertrophy, and both the left ventricle and atrium are dilated due to the transmission of increased pressure. The dilated left atrium particularly is susceptible to getatrial fibrillation。纤颤的中庭面临着在其中形成血栓形成的较高风险。

效果

• In the most advanced cases, the reduction of blood supply to the brain can result in hypoxic encephalopathy
• Pulmonary edema由于肺部血液的次要聚集。
• As previously mentioned, long-standing left heart failure can give rise to right heart failure as well.

Clinical Features of Heart Failure

Most of the clinical features of left and right heart failure are similar to each other. As explained before, left heart failure is most often the cause of right heart failure. Thus, the concurrent presence of both conditions gives a clinical picture with a plenty of shared symptoms and signs. The frequently seen symptoms that give the physicians a clue about the disease are,

• Exertionaldyspnea
• Orthopnea
• 阵发性夜间呼吸困难
• 疲劳和微弱
• Cough
• 身体依赖区域的水肿，例如脚踝。在床约束的患者中，将在s骨区域出现水肿。由于静脉回流的减少，这在右侧心力衰竭中更为明显，这导致血液在身体的依赖区域集合。
• Organomegaly

This is also due to venous congestion. Consequently, features of organomegaly are seen in right heart failure or when the right heart failure is present together with the left heart failure. Liver enlargement (hepatomegaly) is associated with the abnormal distension of the stomach, the appearance of veins around the umbilicus (caput medusae) and failure of the liver functions.

Diagnosis of Heart Failure

通过以下调查证实了心力衰竭的临床怀疑。

• 胸部X射线
• 血液检查

This includes FBC, liver biochemistry, cardiac enzymes released in acute cardiac failure and BNP.

• 心电图
• 超声心动图
• Stress echocardiography
• 心脏MRI。这也称为CMR
• Cardiac biopsy. This is carried out only when a cardiac myopathy is suspected
• 心肺运动测试

Treatment of Heart Failure

生活方式修饰在防止心肌进一步恶化的同时降低并发症（例如心律不齐）的风险中起着关键作用。被诊断出患有心力衰竭的每个患者都建议最大程度地减少酒精的消耗并控制体重。小钠和低盐饮食是心脏病患者的理想选择。通常建议使用床休息，因为它可以最大程度地减少心脏肌肉的压力。

The drugs given in the management of heart failure include

• Diuretics
• 血管紧张素转换酶抑制剂
• Angiotensin II receptor antagonists
• Beta-blockers
• Aldosterone antagonists
• Vasodilators
• 心脏糖苷
• Nonpharmacological interventions used in managing heart failure are,
• 血运重建
• Use of biventricular pacemaker or implantable cardioverter defibrillator
• Cardiac transplantation

右侧和左侧心力衰竭之间的相似之处是什么？

• Clinical features and the management of both conditions are similar to each other.
• 两种情况下，心脏的抽水能力都会损害。

What is the Difference Between Right Sided and Left Sided Heart Failure?

右侧与左侧心力衰竭
When the heart fails to pump blood adequately to the body tissues owing to the decrease in the pumping capacity of the right heart chambers, this condition is identified as the right heart failure.	When the heart failure is due to the faltering of the pumping capacity of the left heart chambers, this is known as left sided heart failure.
Pumping Capacity
In right sided heart failure, pumping capacity of the right heart chambers is decreased.	It is the pumping capacity of the left heart chambers that is decreased in the left sided heart failure.
Causes
右侧心力衰竭最常见于左侧心力衰竭的继发性。 肺部疾病,如支气管扩张、thromboembolism, and COPD are the other causes of this condition.	左侧心力衰竭的原因是 · Ischemic heart diseases ·高血压 ·主动脉和二尖瓣疾病 · Other myocardial diseases such as myocarditis

Summary – Right Sided vs Left Sided Heart Failure

当心脏无法充分泵入身体组织时，由于右心腔的抽水能力降低，该病情被确定为右心衰竭。另一方面，当心力衰竭是由于左心腔的泵送能力的步履蹒跚时，它被称为左侧心力衰竭。因此，右侧和左侧心力衰竭之间的区别在于，在右心力衰竭中，右心腔的功能受损，而左心腔的功能在左心衰竭中受损。

Download PDF Version of Right Sided vs Left Sided Heart Failure

您可以下载本文的PDF版本，并根据引文注释将其用于离线目的。请在此处下载PDF版本Difference Between Right Sided and Left Sided Heart Failure

References:

1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.

Image Courtesy:

1. “Relations of the aorta, trachea, esophagus and other heart structures” By ZooFari(CC BY-SA 3.0)viaCommons Wikimedia
2.国家心脏，肺和血液研究所的“ heartfailure”，国家卫生研究院（公共领域）Commons Wikimedia