In this article, we will discuss the Diagnosis of Left Ventricular Failure. So, let’s get started.
- Full blood count, blood urea, creatinine, electrolytes, etc.
- Arterial blood gas analysis may show low PaO2 with normal or low PaCO3 and low blood pH (metabolic acidosis)
- The ECG may show LVH, arrhythmias, evidence of ischemia or myocardial infarction, LBBB or ventricular strain pattern depending on the cause of LVF
- Chest X-ray will show pulmonary edema (haziness extending from the hilum to periphery) and cardiomegaly. Karley’s B lines may be seen due to alveolar edema. Hydrothorax or left-sided pleural effusion may be evident
- Echocardiogram is most useful investigation and is mandatory in all patients with acute cardiogenic pulmonary edema. It gives valuable information regarding:
(a) Unsuspected yet correctable valvular lesion(s)
(b) Unsuspected cardiac aneurysm
(c) Hypertrophic or dilated cardiomyopathy
(d) Systolic or diastolic LV dysfunction
- Pulmonary capillary wedge pressure is elevated, may be above 25 mmHg. The pulmonary capillary wedge pressure indirectly reflects left atrial pressure.