What are the common clinical manifestations of right sided heart failure?

Clinical presentation. 1.Gastrointestinal symptoms.

Long-term gastrointestinal congestion can cause loss of appetite, bloating, nausea, vomiting, constipation, and epigastric pain.

2.Kidney symptoms.

Renal congestion causes decreased kidney function, less urine during the day and more urine at night. There may be a small amount of proteinuria, a few hyaline or granular casts, and red blood cells. Blood urea nitrogen may be elevated.

3.Pain in the liver area.

Liver congestion and enlargement, dilation of the liver capsule, fullness and discomfort in the right upper abdomen, pain in the liver area, severe pain may occur and misdiagnosed as acute abdomen and other diseases. Chronic heart failure with long-term hepatic congestion can lead to cardiogenic cirrhosis.

4.Dyspnea.

Pulmonary congestion is usually absent in isolated right-sided heart failure, and asthma is not as evident as left-sided heart failure. In the case of left heart failure or in the presence of right heart failure in mitral stenosis, dyspnea is reduced due to reduced pulmonary congestion compared with left heart failure.

Right heart failure is a syndrome in which the right ventricular ejection function decreases after the failure of right heart dysfunction, and is mainly manifested as systemic congestion. Right heart failure is a function of right ventricular pulsation, seen in cor pulmonale, tricuspid or pulmonary valve disease, and often secondary to left heart failure. At this time, cardiac output is reduced, systemic congestion occurs, venous pressure increases, often accompanied by lower extremity edema, and in severe cases, generalized edema may occur.

For right heart failure, there will be symptoms such as edema of both lower limbs, stomach upset, loss of appetite, dizziness and weakness, and jugular venous distention.

Answer] Ming Xing: c

Analysis: The most meaningful and reliable sign for diagnosing right heart failure is a positive hepatojugular venous reflux sign. Right heart failure is mainly a clinical syndrome caused by the reduction of right ventricular output caused by a sharp decline in right ventricular systolic function.

The main clinical manifestations of right heart failure are systemic congestion, mainly jugular venous distension and positive hepatic reflux signs.

Answer]: C Right heart failure is mainly characterized by systemic congestion, and the increased jugular venous pulsation, fullness, and distension are the main signs of body combustion in right heart failure, while the positive hepatojugular venous reflux sign is more characteristic and is the most significant manifestation in right heart failure.

Answer] :d patients with left heart failure have respiratory symptoms in the early stage due to congestion due to lung crumbling, among which exertional breathing difficulty is the most typical symptom. Patients with right heart failure mainly present with systemic congestion, the most common manifestation is gastrointestinal congestion, and clinical discomfort such as abdominal distention, loss of appetite, nausea, and vomiting often occur.

Left-sided heart failure is a clinical syndrome caused by pulmonary congestion and decreased cardiac output.

A common symptom in patients with left-sided heart failure.

1) Dyspnea is the main symptom of left heart failure that appears earlier.

Dyspnea on exertion: dyspnea begins only with heavy physical activity and resolves spontaneously with rest. The main difference between exertional dyspnea in normal and heart failure patients is that the latter also worsens dyspnea with normal activity.

As left ventricular dysfunction worsens, the intensity of exertion that causes dyspnea decreases.

Nocturnal paroxysmal dyspnea: Paroxysmal dyspnea often occurs at night. The patient suddenly wakes up with a severe feeling of suffocation and terror, and sits up quickly, which will take 30 mir or more to relieve.

It is usually accompanied by wheezing in both lungs and is called cardiogenic asthma. The possible mechanism of its occurrence is related to the increase of interstitial fluid reabsorption and return to the heart after bed rest, the increase of vagal tone during sleep, the spasm of the small bronchospasm, the elevation of the diaphragm muscle in the recumbent position, and the decrease of lung capacity.

Orthopnea: Dyspnea occurs quickly when lying down, often in the lying position for 1-2 minutes, and the head needs to be pinched with a pillow. The amount of blood returning to the heart increases in the recumbent position, and the pressure in the left hollow terminal stage of left heart failure increases, which further increases the pressure of the pulmonary veins and pulmonary capillary JHL ducts, causing interstitial pulmonary edema, reducing lung compliance, increasing breathing resistance and aggravating dyspnea.

Acute pulmonary edema: is a further development of cardiogenic asthma.

2) Cough, sputum production, and hemoptysis Cough is an early symptom that often occurs at night, and cough can be reduced or stopped when sitting or standing. The sputum is usually serous, white foamy, and sometimes the sputum is blood-streaked, such as pulmonary capillary pressure is very high, or in pulmonary edema, the plasma extravases into the human alveoli, and there may be pink foamy sputum.

3) Decreased physical strength, fatigue and weakness are almost all common symptoms, and the most common cause is dyspnea after pulmonary congestion. It is also related to the inability to increase the cardiac blood volume normally after exercise, and the decrease in cardiac output leads to insufficient perfusion of tissues and organs. Older people may have mental symptoms such as confusion, decreased memory, anxiety, insomnia, and hallucinations.

Arterial pressure is usually normal, but pulse pressure is reduced.

4) Urinary symptoms When blood flow is redistributed in left heart failure, there is increased nocturia in the early stage. In severe left-sided heart failure, the amount of cardiac blood is severely reduced, renal blood flow is reduced and oliguria occurs, or blood urea and creatinine are elevated and there are corresponding manifestations of renal insufficiency.

Answer]: c Right heart failure is mainly manifested as systemic congestion: (1) edema, symmetrical, depressed edema in the noisy part of the sagging skin; (2) Jugular venosis is manifested as jugular vein filling, distention, liver signs are hepatic congestion, enlargement, tenderness.

1.Symptom.

1) Dyspnea of varying degrees.

1) Exertional dyspnea is the earliest symptom of left heart failure, which is due to the increase of blood volume and left atrial pressure due to exercise, which aggravates pulmonary congestion. The amount of exercise that causes dyspnea decreases as heart failure worsens.

2) When the pulmonary congestion of orthorespiratory breathing reaches a certain level, the patient cannot lie flat, because the amount of blood returning to the heart increases and the diaphragm is raised when lying down, making it more difficult to breathe. Breath-holding can only be improved when lying in a high pillow position, semi-lying position, or even sitting upright.

3) Patients with paroxysmal dyspnea at night have fallen asleep and suddenly wake up due to breath holding, and are forced to sit in a sitting position and breathe deeply and quickly. In severe cases, wheezing may occur, which is called "cardiogenic asthma". Most of them are relieved by sitting upright and resting.

In addition to the increase in pulmonary blood volume due to the redistribution of blood during sleep, the mechanism of this is also a contributing factor, such as increased vagus tone at night, constriction of the small bronchi, high diaphragm, and decreased lung capacity.

4) Acute pulmonary edema is a further development of "cardiogenic asthma" and is the most severe form of dyspnea in left heart failure.

2) Cough, sputum, hemoptysis, and sputum are caused by congestion of the alveolar and bronchial mucosa, which often occurs at night, and can be relieved when sitting or standing, and is characterized by white serous foamy sputum. Occasionally, blood-streaked sputum may be seen. Long-term chronic congestion increases pulmonary venous pressure, resulting in the formation of collateral branches between the pulmonary and bronchial blood circulation, and the formation of dilated blood vessels under the bronchial mucosa, which can cause massive hemoptysis if ruptured.

3) Fatigue, tiredness, dizziness, and palpitation are the main symptoms caused by insufficient cardiac output, insufficient perfusion of organs and tissues, and compensatory increased heart rate.

4) When the blood of left heart failure with severe symptoms of oliguria and renal impairment is redistributed, first of all, the blood flow of the kidneys is significantly reduced, and the patient may have oliguria. Long-term chronic renal blood flow reduction may result in elevated blood urea nitrogen, creatinine, and associated symptoms of renal insufficiency.

2.Signs. 1) Wet rales in the lungs due to the increased pressure of the pulmonary capillaries, and the fluid can leak into the alveoli and cause wet rales. As the disease progresses from mild to severe, rales in the lungs can be localized to the base of the lungs and to the whole lung. If the patient is in the lateral decubitus position, there are more rales on the drooping side.

2) Cardiac signsIn addition to the intrinsic signs of underlying heart disease, patients with chronic left heart failure generally have cardiomegaly (except for isolated diastolic heart failure), hypersecond heart sound in the pulmonary valve area, and diastolic gallop rhythm.

Exertional dyspnea is the earliest symptom of left-sided heart failure, paroxysmal dyspnea at night, sudden awakening after deep sleep, may be accompanied by shortness of breath, cough, frothy sputum, cough, sputum and hemoptysis, the sputum is often white foamy, and the severe sputum is pink frothy sputum.

What are the clinical manifestations of heart failure.

Hello,Gastrointestinal symptoms: abdominal distention, loss of appetite, nausea, vomiting, etc. caused by gastrointestinal and liver congestion are the most common symptoms of right heart failure; ⑵.

Exertional dyspnea: dyspnea secondary to left-sided heart failure and right-sided heart failure are already presentEdema:

It appears first in the lowest part of the body, which is usually symmetrical and collapsible.

1. The veins of the neck are full and distended.

2. Gastrointestinal congestion leads to bloating, anorexia, nausea, etc.

3. Dyspnea: right ventricular enlargement affects left ventricular diastolic, pulmonary congestion 4Edema of both feet and legs, spreading upwards throughout the body.

5.Pleural and ascites due to systemic congestion.

Right heart failure is mainly due to systemic venous congestion and is characterized by the following symptoms:

1. Edema: appears in the low-hanging part of the calf or foot, and in severe cases, pleural effusion or even pericardial effusion occurs;

2. Gastrointestinal congestion: manifested as decreased appetite, abdominal distention, nausea, vomiting and other symptoms;

3. Dyspnea on exertion;

4. Jugular venous distention;

5. Obvious liver congestion and hepatomegaly;

6. Positive hepatocervical reflux sign, which is a unique sign caused by systemic congestion in patients with right heart failure.

Right heart failure is caused by obstruction of venous return in different parts of the body, and each organ produces corresponding clinical symptoms. The specific situation is as follows: 1. Edema:

appears in the lower leg or foot in a low-hanging area, and in severe cases, pleural effusion or even pericardial effusion; 2. Gastrointestinal congestion: manifested as decreased appetite, abdominal distention, nausea, vomiting and other symptoms; 3. Dyspnea on exertion; 4. Jugular venous distention; 5. Obvious liver congestion and hepatomegaly; 6. Positive hepatocervical reflux sign, which is a unique sign caused by systemic congestion in patients with right heart failure.

The most typical feature of right-sided heart failure is a syndrome characterized by systemic congestion.

1) Gastrointestinal symptoms: Long-term gastrointestinal congestion can cause loss of appetite, bloating, nausea, vomiting, constipation and epigastric pain.

2) Renal symptoms: renal congestion causes renal function to decrease, less urine during the day and more urine at night. There may be a small amount of proteinuria, a few hyaline or granular casts, and red blood cells. Blood urea nitrogen may be elevated.

3) Pain in the liver area: hepatic congestion and enlargement, dilation of the liver capsule, fullness and discomfort in the right upper abdomen, pain in the liver area, severe pain can occur and misdiagnosed as acute abdomen and other diseases. Chronic heart failure with long-term hepatic congestion can lead to cardiogenic cirrhosis.

Typical symptoms: depressed edema of both lower extremities appears early, and generalized, symmetrical pitting edema may occur in the late stage.