Physiological Adaptation Q 166
Which of the following symptoms is most commonly associated with left-sided heart failure?
A. Crackles
B. Arrhythmias
C. Hepatic engorgement
D. Hypotension
Correct Answer: A. Crackles
Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system. The left ventricle of the heart no longer pumps enough blood around the body. As a result, blood builds up in the pulmonary veins (the blood vessels that carry blood away from the lungs). This causes shortness of breath, trouble breathing or coughing – especially during physical activity. Left-sided heart failure is the most common type.
Option B: Arrhythmias can be associated with both right and left-sided heart failure. Cardiac arrhythmia is an abnormal rate and/or rhythm of a heart due to its abnormal electrical impulse origination and/or propagation. Various etiologies can cause arrhythmias. Heart failure (HF) is a clinical syndrome due to an impaired heart that can not pump sufficient blood to meet the systemic metabolic needs.
Option C: Hepatomegaly is prominent with chronic right-sided heart failure. The primary pathophysiology involved in hepatic dysfunction from HF is either passive congestion from increased filling pressures or low cardiac output and the consequences of impaired perfusion. Passive hepatic congestion due to increased central venous pressure may cause elevations of liver enzymes and both direct and indirect serum bilirubin.
Option D: Left-sided heart failure causes hypertension secondary to an increased workload on the system. Hypertension increases the workload on the heart inducing structural and functional changes in the myocardium. These changes include hypertrophy of the left ventricle, which can progress to heart failure.