A 70 year old man was brought to the emergency room by his son with complaints o

Question

A 70 year old man was brought to the emergency room by his son with complaints of 3 week history of restlessness confusion, fatigue, dyspnea, orthopnea paroxysmal nocturnal dyspnea, and pedal edema According to his past medical history, he has hypertension, diabetes mellitus and is being treated for them He suffered a myocardial infarction 1 year gyp and had stent placement in the left coronary artery On current examination, this patient has a pitting edema of his lower limbs, a soft murmur is heard while auscultating his heart and bilateral crackles are heard while auscultating his lungs The attending physician concludes that the patient is suffering from Heart failure Physical exam findings: Lab findings Blood pressure 105/60 mm Hg Hemoglobin 13mg/dl| Pulse rare 110/min W B C count 8, 500/microliter Pitting pedal edema Platelets 350,000/microliter Heart murmur heard Lung Crackles heard Serum electrolytes: Patient Values Normal Range Sodium 130 mEg/L (136- 146 mEq/L) Potassium 4 8 mEq/L (3 5-50mEq/L) Calcium 9 mg/dl (8-10 mg/dl) Phosphorous 4 mg/dl (3.0 - 4 5 mg/dl) Which sided heart failure is the patient suffering from? What are the differences between Left heart failure and right heart failure? What happens to the flow of blood into the body in this type of heart failure? What other symptoms does the patient suffer from due to this altered blood flow through the body?,

Explanation / Answer

The case is revealing that patient has left sided heart failure. It is because the sound of lung crackles is increased. It is a sign of pulmonary edema, when fluid is backed from left ventricle and stored into alveoli that cause the several hearding of crackles, bilateral hearding.

In right heart failure, blood is accumulated in the body in large amount. This is results into swelling under skin, the peripheral edema. This failure is happened due to pulmonary heart disease, where right ventricle fails to response adequately for the blood pressure.

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