When the left ventricle fails, cardiac output decreases. Blood pools in the left ventricle and backs up into the left atrium and pulmonary vessels. The pooling blood pushes fluid into the pulmonary capillary bed, causing pulmonary congestion and respiratory problems. The patient develops dyspnea and fatigue. You may auscultate crackles at her lung bases, and her chest X-ray may show pleural effusion.
Pulmonary edema is an acute complication of left ventricular failure.
It occurs when pressure in the pulmonary vessels becomes so great that fluid is pushed into the interstitial spaces and alveoli. The patient develops air hunger, diaphoresis, and acute respiratory distress and may cough up pink, frothy sputum. Auscultating her lungs, you may hear crackles throughout the lung fields and an S 3 heart sound. The chest X-ray typically indicates large white patchy areas from accumulated multiple infiltrates. Right ventricular failure occurs when the right ventricle loses the ability to pump enough unoxygenated blood from the right ventricle into pulmonary vessels.