Management Of Acute Left Ventricular Failure

Management Of Acute Left Ventricular Failure

Question. Describe the management of acute left ventricular failure.

Answer.

Management Acute Left Ventricular Failure:

First aim of treatment is to fid and remove the precipitating cause, i.e. arrhythmia or an intercurrent infection.

• Patient should be kept in sitting position, with legs hanging along side of the bed, i.e. upright posture should be maintained.
• Diet: Salt free diet is given till left ventricular failure improves and later on restricted salt diet is given.
• Sedatives: Morphine should be given in doses of 5 to 10 mg along with an anti­emetic, i.e. metaclopramide 10mg I.V. and repeat the drug as soon as desired.

Management of Acute Left Ventricular Failure

• Oxygen: About 60% of oxygen is given by facemask under positive pressure. It should be given as 6 to 8 L/min through Wolfe’s botte.
• Loop diuretics: Furosemide 40 to 100 mg IV should be given.
• IV sodium nitroprusside 20 to 30µg/min or IV nitroglycerin should be given in patients whose systolic blood pressure is more than 100 mm Hg.
• Digitalis: If digoxin is not used previously, the three fourth of full dose, i.e. 0.5 to 1mg is given as IV dose.
• Bronchodilators: Attmes aminophylline or theophylline in dose of 250 to 500 mg I.V. decreases brochoconstriction.
• In cases of severe left ventricular failure inotropes can be given.
• If all the above measures failed then rotating tourniquet should be applied to extremities.
• Intra-aortic balloon counterpulsation: It is used in acute left ventricular failure during cardiac procedures or cardiac repairs.

Acute Left Ventricular Failure: Causes, Symptoms, and Treatment