A 72 year old man comes to the physcian because of a 8 month history of progressive dyspnea on exertion and fatigue. Auscultation of the chest shows cracles bilaterally and an S3. There is no jugular venous distention, hepatojugular reflux or pedal edema. Which of the following hemodynamic findings is most likely in the patient ? A. Decreased left ventricular ejection fraction B. Decreased left ventricular preload C. Decreased right ventricular preload D. Increased Left ventricular Stroke volume E. Increased Right ventricular ejection fraction F. Increased right ventricular stroke volume
A 72 year old man comes to the physcian because of a 8 month history of progressive dyspnea on exertion and fatigue. Auscultation of the chest shows cracles bilaterally and an S3. There is no jugular venous distention, hepatojugular reflux or pedal edema. Which of the following hemodynamic findings is most likely in the patient ?
A. Decreased left ventricular ejection fraction
B. Decreased left ventricular preload
C. Decreased right ventricular preload
D. Increased Left ventricular Stroke volume
E. Increased Right ventricular ejection fraction
F. Increased right ventricular stroke volume
Left sided heart failure is usually associated with coronary artery disease. hypertension and valvular heart disease. It is divided into systolic and diastolic heart failure. Systolic heart failure is seen with reduced ejection fraction usually. Whereas diastolic heart failure is associated with preserved ventricular function.
In left sided heart failure patient may manifest with symptoms of pulmonary congestion like cough, crackles, tachypnea, pink tinged sputum, tachycardia, fatigue, cyanosis, and exertional dyspnea. The presence of S3 sound also is an initial clue suggesting left ventricular dysfunction & left heart failure.
Right sided heart failure is associated with left ventricular failure, right sided MI (myocardial infarction), or pulmonary hypertension. This can occur secondary to pulmonary problems like COPD. Manifestations include peripheral edema, ascites, enlarged liver & spleen, weight gain, jugular venous distension, and increased peripheral venous pressure.
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