Left-Sided Failure
When the left ventricle fails, blood backs up into the lungs. Patients present with dyspnea, orthopnea, crackles, frothy pink sputum, and sometimes wheezing. They often prefer to sit upright.
Right-Sided Failure
When the right ventricle fails, blood backs up into the systemic circulation. Look for jugular vein distention, peripheral edema, hepatomegaly, and ascites. Right-sided failure frequently results from left-sided failure or chronic lung disease.
Management
Position the patient upright, give high-flow oxygen, and consider CPAP if available and indicated. Keep the patient calm, and monitor for signs of shock. Assist with prescribed medications such as nitroglycerin only if blood pressure allows, and transport promptly.