Is the left side of your heart also weak? (Left-Sided Heart Failure) - Let's talk about this!

Do you sometimes feel short of breath? Or do you feel short of breath when you walk, bend over, or do some work? Do you have to sit up at night because you feel suffocated when you lie down to sleep? Do you have swelling in your legs and ankles? These can sometimes be signs of a weak left side of the heart. Today, we will talk about this condition called `(Left-Sided Heart Failure)` in a simple way that you can understand. Don't be afraid, it is very important to be aware of this.

What is Left-Sided Heart Failure?

Simply put, this means that the left side of our heart is unable to do its job, which is to pump blood throughout the body, properly. Think of it like a water pump. If it's not working properly, the water won't go to the tank. That's how it is. There are two main types of this:

1. Systolic heart failure: This is when the main pumping chamber on the left side of the heart, called the left ventricle, contracts and becomes weak enough to pump blood throughout the body. This means that the amount of blood the heart pumps (the ejection fraction) decreases. Just as when the power of a motor is insufficient, the pressure that pumps water decreases.

2. Diastolic heart failure: This is a different situation. Although the left ventricle is strong, it does not relax well and does not stretch as much as it should to fill with blood. This means that the heart chamber becomes stiff. It is like trying to fill a stiff, inflexible balloon with water, and it has difficulty filling with blood. In this case, the amount of blood the heart pumps (ejection fraction) may be normal.

Do you understand the difference between these two types now?

How do the left and right sides of our heart work?

Our heart is a truly amazing organ. It works like a powerful pump, working non-stop. It has two main sides, the left side and the right side. Each side does a different job.

• Left side: This side is the main character of our story. The left side of the heart receives oxygenated, clean blood from the lungs. This blood is then distributed throughout the body, from the brain to the feet, to every organ, muscle, and tissue. This oxygen gives every part of our body the energy and life it needs to do its job.

• Right side: The right side collects blood that has been used in the body, that is, blood that has lost oxygen and accumulated carbon dioxide, and sends it back to the lungs to be cleaned. It is in the lungs that we exhale carbon dioxide and add new oxygen to the blood.

In this way, the two sides work together to maintain proper blood circulation in our body.

What causes the left side of the heart to become weak?

Imagine, what would happen if we used the water pump in our house for years without any maintenance or service? Little by little, its parts would wear out, its efficiency would decrease, and it could eventually stop working, right? That's how it is with our heart. Some diseases and our bad habits can damage the left side of the heart over time, making it weak. Here are some of the main reasons:

• Coronary artery disease: This is when fat deposits build up inside the blood vessels (coronary arteries) that supply blood to the heart. This prevents the heart muscle from getting the oxygen and nutrients it needs.
• Heart attack: A heart attack is a sudden interruption of blood flow to the heart. This causes part of the heart to die, reducing the heart's ability to pump.
• High blood pressure (`High blood pressure`) not controlled for a long time: When the pressure is consistently high, the heart has to work harder to pump blood. Over time, the heart becomes tired and weak.
• Heart valve defects (`Valvular heart disease`): If the valves in the heart do not close or open properly, blood flow is disrupted and the heart feels an increased burden.
• Abnormal heart rhythms (Arrhythmia): When the heart does not beat in the right rhythm, its pumping efficiency decreases.
• Some rare medical conditions: For example, conditions such as `(Amyloidosis)` (deposition of an abnormal protein in the heart) or `(Sarcoidosis)` (formation of small lumps in the heart) can also cause the heart muscle to become stiff and weak.

Important: One or more of these causes can cause weakness in the left side of the heart.

In addition to this, there are several other risk factors that increase the risk . This means that people with these things are more likely to develop weakness in the left side of the heart:

• Some chemotherapy treatments for cancer can cause side effects on the heart (cardiotoxicity).
• Diabetes.
• Obesity.
• Sleep apnea.
• As we age, our heart's function may naturally decrease slightly.
• Smoking and breathing in other people's smoke.
• Continued use of certain drugs and energy drinks, which are harmful to the heart.
• Very rarely, some medications used to treat other conditions (e.g., autoimmune diseases, attention-deficit/hyperactivity disorder (ADHD)) may also be affected.

What are the symptoms of this condition?

At first, when the left side of the heart starts to weaken, you may not notice any major symptoms. You may think , "Oh, it's just a cold" or "It's just something that happens when you get older." But as your heart's function gets worse, you may start to notice things like:

• A persistent cough: You should be concerned if you cough, especially at night or when lying down.
• Shortness of breath:
• When I walk a little, climb a few stairs, and bend over, I get a headache.
• When I wake up at night, I feel like I have a hard time breathing, as if my chest is constricting.
• It is difficult to sleep when lying down, and it feels easier to breathe when sitting up. (This is because more fluid accumulates in the lungs when lying down).
• Sudden weight gain: You may gain a kilo or two in a few days. This is not actually getting bigger, but rather fluid retention.
• Swelling (edema): Swelling of the ankles, legs, and sometimes the abdomen. This is also caused by fluid retention in the body.

Over time, as the heart works harder to do its job, complications such as:

• Cardiogenic shock: This is an emergency. The heart is unable to pump enough blood, resulting in a lack of blood flow to the body's vital organs.
• Enlarged heart: When the heart works too hard, its muscles thicken and the heart becomes larger.
• Heartbeat abnormalities (`Arrhythmia`): The heart's rhythm may become irregular.

If you have any of these symptoms, please see a doctor.

How does a doctor detect this?

When you go to a doctor, they first ask you a lot of questions. What are your symptoms, how long have you had them, does anyone in your family have heart disease, what medications you take, and so on. Then they examine you. They listen to your heart, check your lungs, and look for swelling.

In addition, the following tests (laboratory tests and imaging studies) can be performed to confirm the exact condition and find the cause:

• Blood tests (`Laboratory tests`):
• BNP (B-type natriuretic peptide) blood test: This is a special biomarker. When the pressure in the heart chambers increases, this hormone is released into the blood. Its levels can give an idea of ​​whether the heart is weak.
• `Metabolic panel`: This checks kidney and liver function, as well as the levels of salts in the blood, such as sodium and potassium. These are important in heart disease.

• Imaging studies:
• Electrocardiogram (ECG/EKG): This records the electrical activity of the heart. It can detect things like a heart attack or a heart rhythm problem.
• Echocardiogram (ECHO): This is like an ultrasound scan of the heart. It can clearly see many things, such as the size of the heart's chambers, the thickness of the walls, the function of the valves, and the way the heart pumps blood (ejection fraction).
• Coronary angiography: A special X-ray test to check for blockages in the coronary arteries that supply blood to the heart.
• Cardiac MRI (Cardiac Magnetic Resonance Imaging): This can take very clear, detailed pictures of the heart. It can help identify things like the condition of the heart muscle and areas of damage.

Based on the information obtained from these tests, the doctor will decide what kind of condition you have and what the best treatment is for it.

How is it treated? What medications are available?

The good news is that there are a number of treatments for left-sided heart failure. The treatment that's right for you will depend on whether you have the previously mentioned ``Systolic heart failure'' or ``Diastolic heart failure'', as well as the severity of the condition.

Medications are often the primary treatment. These medications help improve heart function, reduce symptoms, and prolong life. Here are some of the most commonly used medications:

• ACE inhibitors (angiotensin-converting enzyme inhibitors), Angiotensin II receptor blockers (ARBs), Angiotensin-receptor neprilysin inhibitors (ARNIs): These classes of drugs work by relaxing blood vessels, lowering blood pressure, and helping the heart to remodel.
• Aldosterone antagonists: These control stress-related hormones and prevent symptoms from getting worse. They also help reduce swelling by reducing water retention (a mild diuretic).
• Beta blockers: These medications slow down the heart rate and reduce the workload on the heart, that is, the amount of work it has to do.
• Digoxin: This medication helps some people, especially those with certain heart rhythm disorders, feel better and control their heart rate.
• Diuretics: These work by removing excess fluid from the body through urine, which can reduce symptoms such as shortness of breath and swelling.
• Sodium-glucose transport protein 2 (SGLT2) inhibitors: This new class of drugs is very useful for people with and without diabetes who have heart failure. They also help reduce excess fluid in the body and protect the heart.

Remember: It is essential to take these medications exactly as prescribed by your doctor, in the correct dosage, and at the correct time. Never stop taking the medication or change the dosage without your doctor's advice.

Do some people have to undergo special treatments (`procedures`)?

Yes, in some cases, if symptoms cannot be controlled with medication alone, or if tests show that the heart condition is getting worse, the doctor may recommend special procedures or surgery. Here are some of them:

• Cardiac resynchronization therapy (CRT): This involves implanting a small device (like a pacemaker) under the skin that delivers electrical stimulation to help both the left and right chambers of the heart contract at the same time. This is also called a biventricular pacemaker. This makes the heart's pumping action more efficient.
• Electrical cardioversion: A treatment that delivers an electrical shock to the chest to restore normal heart rhythm when the heart is irregular.
• Implantable cardioverter defibrillator (ICD): This is also a device that is placed under the skin. It detects dangerous heart rhythm irregularities and automatically sends electrical signals to restore them to normal.
• Left ventricular assist device (LVAD): This is a pump that is surgically implanted inside the heart to help the heart pump blood. It is used for people with severe heart failure who are waiting for a heart transplant.
• Heart transplant: For patients with severely weakened hearts who have failed all other treatments, a transplant of a healthy heart from a deceased donor is the last resort.

What can we do to avoid this situation? (Prevention)

There is a saying that "Prevention is better than cure." That applies here too. Following a heart-healthy lifestyle can greatly reduce the risk of left-sided heart failure. If you already have this condition, good habits can help prevent future problems and manage the condition.

Here are some things you can do:

• Keep your blood pressure, cholesterol levels, and diabetes under control if you have them. Take the medications your doctor prescribes.
• Exercise regularly. Do simple exercise like walking for at least 30 minutes a day.
• Make time for a good night's sleep . You need 7-8 hours of sleep a day.
• Maintain a healthy body weight. Obesity is a big burden on the heart.
• Eat a healthy diet. Eat more fruits, vegetables, legumes, and fiber-rich foods. Reduce salt, sugar, and oil.
• Reduce stress. Do things like yoga, meditation, breathing exercises (`relaxation techniques`). Engage in a hobby you enjoy.
• If you smoke, stop immediately. Stay away from places where others smoke (`secondhand smoke`).
• Limit or completely stop alcohol use .

What will life be like if the left side of the heart becomes weak? What are the possible complications?

If you follow your doctor's instructions exactly, use your medications correctly, and go to follow-up appointments on time, you can maintain your health very well. Most people can live a normal life.

However, if this condition is not properly controlled, some complications may occur. Here are some of them:

• Heart rhythm irregularities (`Arrhythmias`): For example, ``ventricular tachycardia`` (fast heartbeat), ``atrial fibrillation / Afib`` (irregular heartbeat of the atrium).
• Sleep apnea (obstructive and central sleep apnea).
• Heart valve problems (`Heart valve disease`), such as blood leaking backward through the valves.
• Liver disease: When the heart does not pump blood properly, the liver can also be affected.
• Right-sided heart failure: When the left side of the heart becomes weak, it can also affect the right side.
• Frailty and muscle weakness.
• Anemia.
• Kidney disease: When the heart weakens, the amount of blood flowing to the kidneys decreases, which can affect their function.
• Depression or Anxiety: Living with a long-term illness can also have psychological effects.

What do we need to change while living with this situation?

When living with left ventricular dysfunction, there are some important lifestyle changes you can make to help manage your condition, reduce symptoms, and make life easier.

• Be a little more physically active than before: Engage in exercises that are appropriate for you, as recommended by your doctor.
• Check your blood pressure every day: Record it as your doctor tells you.
• Continue to take your heart failure medication exactly as prescribed: don't miss a single day.
• See your doctor on time and go to clinics: This will help the doctor monitor your condition and make any necessary changes.
• Reduce salt in your diet: Salt can increase water retention in the body, leading to swelling and difficulty breathing.
• Weigh yourself every morning: at the same time, in the same way (e.g., after using the bathroom, before getting dressed). If you gain a kilo or two in a day or two, it could be water retention. If that happens, tell your doctor.
• Drink only the amount of fluids (such as water, tea, soup) prescribed for you per day: Some people need to control their fluid intake.

Finally, what to remember (Take-Home Message)

Simply put, Left-Sided Heart Failure is a condition in which the heart's ability to pump blood is reduced, and it is something to be concerned about. This is most common in people with heart conditions such as high blood pressure, coronary artery disease, and heart failure.

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However, there is no reason to panic. If you recognize the symptoms of this condition early, treat it properly according to medical advice, use the prescribed medication, and follow a heart-healthy lifestyle, you can live well and comfortably with this condition.

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Therefore, if you have any of the symptoms mentioned in this article, the best thing you can do for yourself is to see a qualified doctor immediately and seek advice without ignoring it. The sooner the disease is diagnosed, the more likely it is that the treatment will be successful. Wishing you good health!

` Heart failure, Left-Sided Heart Failure, Shortness of breath, Swelling, Heart disease, Heart attack, High blood pressure