What are the main manifestations of left heart failure?

Clinical Manifestations of Left Heart Failure

The primary clinical manifestations of left heart failure include dyspnea, cough with hemoptysis, fatigue, renal function impairment, etc. Details are as follows:

1. Various Types of Dyspnea

a. Exertional dyspnea: Typically occurs after physical activity, with the threshold of activity reflecting the severity of the disease.

b. Orthopnea: Patients cannot lie flat due to pulmonary congestion, and symptoms improve when they sit upright with a high pillow or in a semi-recumbent position.

c. Paroxysmal nocturnal dyspnea: Characterized by waking up from sleep due to dyspnea.

d. Acute pulmonary edema: A severe manifestation also known as cardiogenic asthma.

2. Cough, Sputum Production, and Hemoptysis

Mostly occurs at night, with white frothy sputum. Occasionally, there may be blood-tinged sputum. Coughing reduces when sitting or standing. During acute left heart failure, pink frothy sputum may appear. Chronic pulmonary congestion increases pulmonary venous pressure, leading to collateral formation beneath the bronchial mucosa between pulmonary and bronchial circulations. Rupture of these vessels can cause massive hemoptysis.

3. Symptoms Related to Insufficient Organ and Tissue Perfusion and Compensatory Tachycardia

These include fatigue, weariness, reduced exercise tolerance, dizziness, palpitations, etc., caused by inadequate perfusion and compensatory tachycardia.

4. Oliguria and Renal Function Impairment

Heart failure leads to blood redistribution, resulting in insufficient renal perfusion and subsequently oliguria. Prolonged conditions can further impair renal function, manifested by elevated blood urea nitrogen and creatinine levels, accompanied by other symptoms of renal insufficiency.