Core Concepts & Takeaways

Signs and symptoms of LVF:

• Severe respiratory distress: Orthopnea, Spasmodic cough that may produce foamy, blood-tinged sputum, and a history of paroxysmal nocturnal dyspnea (a sudden episode of dyspnea that occurs after lying down)
• Severe apprehension, agitation, confusion
• Cyanosis (if severe)
• Diaphoresis
• Adventitious lung sounds
  • Bilateral crackles that do not clear with coughing (usually present at the base of the lungs and up to the level of the scapulae)
  • Rhonchi (fluid in the upper airways)
  • Wheezes (reflex airway spasm, sometimes referred to as cardiac asthma)
• JVD (indicates back pressure through the right heart and into the venous system)
• Abnormal vital signs: Abnormal vital signs:  possibly elevated Blood pressure and rapid pulse rate to compensate for low stroke volume.  Pulse rate possibly irregular if dysrhythmias are present.
• Regular alterations of weak and strong beats without changes in the length of the cycle (pulsus alternans); rapid, labored respirations
• Altered level of consciousness (patient may be anxious, agitated, uncooperative, or obtunded because of poor cerebral perfusion or hypoxia)
• Chest pain: present or absent.  Pain may be masked by respiratory distress.