Left-Side CHF 1

Running head: LEFT-SIDE CONGESTIVE HEART FAILURE

Left-Side Congestive Heart Failure

Elisabeth Fandrich

Montana Tech Nursing Department

NURS 1566 Core Concepts of Adult Nursing

April 10, 2008

Noel Mathis RN, BSN, MSN

Left-Side Congestive Heart Failure

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When the heart does not pump as strongly as it should, it cannot perfuse the body effectively.

Some of the blood that would normally be pumped out of the heart to the body systems backs up

into the lungs and other parts of the body, most commonly the legs and feet. When fluid collects

in the lungs, it will interfere with breathing causing shortness of breath, and difficulty breathing,

especially when lying supine.

Congestive heart failure can be caused by chronic hypertension, congenital heat defects, heart

valve disease, cardiomyopathy, history of heart attack or myocardial infarction (scar tissue

interferes with the pumping action), chronic kidney failure, coronary artery disease or infection of

the heart muscle or valves. Congestive heart failure is more common in individuals over the age

of 70 than in other demographic groups. Other causative factors are over- or under-active thyroid

hormone production and chronic excessive consumption of alcohol. Precipitating factors that can

trigger congestive heart failure in patients with already enfeebled hearts are obesity, stress, high

sodium or fluid intake, fever, infection of the lungs, tachycardia and pulmonary embolism.

Symptoms of congestive heart failure are dependant on the side of the heart that is impaired.

Left-side congestive heart failure causes pulmonary edema. This results in shortness of breath and

fatigue during mild exertion, shortness of breath during sleep, wheezing, and a “hacking” cough.

The symptoms of left-side congestive heart failure and those of pneumonia are very similar,

because they both result from the accumulation of fluid in the lungs. 346,K,B was had been

treated for pneumonia at a local clinic, and when the symptoms did not resolve, she became

concerned and came to the emergency room. The patient’s admitting diagnosis was pneumonia.

Initial blood labs were drawn and showed low RBC (3.73), low Hgb (11.4), low Hct (33.9),

slightly high % Neuts (74.6%), low % Lymphs (16.1), high sedimentation rate (28), high glucose

(124), high TSH (5.50) and no growth in the blood cultures. These values indicate fluid volume

excess due to pulmonary edema, absence of infection and underactive thyroid hormone secretion.
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Along with assessment data gathered (in particular, tachycardia), further heart studies were

indicated. EKG showed sinus tachycardia with fusion complexes and left bundle branch block. A

chest CT showed coronary arterial calcifications and bilateral pleural fluid collections. An

echocardiogram was ordered. The results of that test were not available to me. Synthroid was

ordered to correct the low thyroid hormone level. The determination was made by the patient’s

primary care physician and cardiac specialist that the patient did not have pneumonia as previously

thought, but in fact has left-side congestive heart failure.

Treatment of congestive heart failure first focuses on correcting any underlying causes. 346, K,B

had inadequate secretion of thyroid hormone, and Synthroid was ordered to correct the

imbalance. Lifestyle changes are often indicated, including smoking cessation, weight reduction,

diet adjustments, daily exercise, and reduction of alcohol consumption. Medications designed to

improve perfusion and improve cardiac efficiency are often indicated. An example of this type of

medication is Digoxin. This medication causes the heart rate to slow, and the heart to beat more

forcefully. This medication was also ordered for 346,K,B. Vasodilators are often ordered, to ease

the flow of blood through the body, thus reducing the workload of the heart. Diuretics are

ordered to reduce fluid retention. Lasix was ordered for 346, K, B to abate the pulmonary

edema. In many cases, morphine is ordered to relieve the anxiety that is often felt by patients with

pulmonary edema. In severe cases of congestive heart failure, heart transplant may be necessary.

There are several types of devices that can be implanted which may help increase the longevity of

the diseased heart. 346,K,B was also prescribed ASA and Plavix to reduce the risk of

development of a clot which would have the potential of becoming a pulmonary embolus.

Follow up lab work of 346,K,B showed only slight changes in the abnormal values. More blood

work was ordered, but the results of that were not available to me. The patient was being treated

for pneumonia. I did not get a chance to see if the new treatment regimen would improve the
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patient’s health status. For many patients with mild to moderate congestive heart failure,

improvement can be achieved by implementing lifestyle changes, correcting underlying causative

factors, and medication.

References

(2008). Congestive heart failure. Retrieved April 10, 2008, from American Heart Association 

Web site: http://www.americanheart.org/presenter.jhtml?identifier=4585
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Congestive Heart Failure. (2008). Congestive Heart Failure. In Penn State Health & Disease  

Information [Web]. Hershey, PA: Penn State Milton S. Hershey Medical Center College of 

Medicine. Retrieved April 10, 2008, from http://www.hmc.psu.edu/healthinfo/c/chf.htm

Pneumonia ­ Symptoms. (2007). Pneumonia ­ Symptoms. In WebMD Medical Reference [Web]. 

New York, NY: HealthWise, LLC.. Retrieved April 10, 2008, from http://www.webmd.com/a­to­

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