What type of heart failure is characterized by manifestations including hepatosplenomegaly, Jugular Venous Distension (JVD), decreased urine output, dyspnea, and frothy sputum?

From the Guidelines

Right-sided heart failure is characterized by manifestations including hepatosplenomegaly, Jugular Venous Distension (JVD), decreased urine output, dyspnea, and frothy sputum.

Key Characteristics

• Hepatosplenomegaly and JVD are signs of right-sided heart failure, as they indicate congestion in the systemic veins 1.
• Decreased urine output is a sign of hypoperfusion, which can occur in right-sided heart failure due to reduced cardiac output 1.
• Dyspnea and frothy sputum are signs of pulmonary congestion, which can occur in right-sided heart failure due to increased pressure in the pulmonary capillaries 1.

Clinical Assessment

• The physical examination is the primary step in evaluating the presence and severity of fluid retention in patients with heart failure, including right-sided heart failure 1.
• The most reliable sign of volume overload is jugular venous distention, which is a key characteristic of right-sided heart failure 1.
• Other signs of right-sided heart failure include peripheral edema, hepatomegaly, and ascites 1.

Pathophysiology

• Right-sided heart failure can result from disorders of the pericardium, myocardium, endocardium, or great vessels, and can be associated with a wide spectrum of functional abnormalities 1.
• The clinical syndrome of right-sided heart failure may be classified as predominantly right backward failure, which is characterized by congestion in the systemic veins 1.

From the Research

Heart Failure Characterized by Hepatosplenomegaly, JVD, and Other Symptoms

The type of heart failure characterized by manifestations including hepatosplenomegaly, Jugular Venous Distension (JVD), decreased urine output, dyspnea, and frothy sputum is right heart failure (RHF) 2.

Clinical Signs and Symptoms

Key clinical signs of RHF include:

• Swelling of the neck veins with an elevation of jugular venous pressure
• Ankle oedema
• Congestive hepatomegaly
• Ascites
• Peripheral oedema

These symptoms occur due to the incompetence of the right heart to maintain systemic venous pressure sufficiently low to guarantee an optimal venous return and to preserve renal function 2.

Diagnosis and Prognosis

Diagnosis of RHF requires the presence of signs of elevated right atrial and venous pressures, including dilation of neck veins, with at least one of the following criteria:

• Compromised RV function
• Pulmonary hypertension
• Peripheral oedema and congestive hepatomegaly 2 The presence and extent of JVD and lower extremity edema are better than other signs and symptoms in identifying severity of HF exacerbation among patients with EF ≤ 30% 3.

Associated Conditions

RHF may result from various conditions, including:

• Coronary artery disease
• Hypertension
• Valvular heart disease
• Cardiomyopathies
• Myocarditis 2 Liver abnormalities, such as passive hepatic congestion and impaired perfusion, can also occur in heart failure due to increased central venous pressure or low cardiac output 4.