Diagnosis of Left Ventricular Failure

In this article, we will discuss the Diagnosis of Left Ventricular Failure. So, let’s get started.

Investigations

  • 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.
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