Key result
Left ventricular failure may occur before right ventricular failure, leading to pulmonary congestion and paroxysmal dyspnea, a concept historically described but often overlooked.
Discusses the historical and pathophysiological concept of isolated left ventricular failure leading to pulmonary congestion.
Alerts clinicians to isolated LV failure in paroxysmal dyspnea; leaves open prospective validation in modern cohorts.
That failure of the left ventricle may occur before failure of the right ventricle, resulting in pulmonary congestion with perhaps little or no engorgement of the peripheral veins, explains the basic factors in the production of paroxysmal dyspnea commonly referred to as cardiac asthma. The conception of left ventricular failure is not new, for, as pointed out by White,1Weiss and Robb2and Harrison,3it was clearly described by Hope in 1833. Unfortunately, however, it has been overlooked or disregarded for the most part by the recent generations of our profession until the past few years. In the cardiac disability resulting from hypertension, arteriosclerosis of the coronary arteries, syphilitic aortitis and disease of the aortic valve, the dominant effect is on the left ventricle. This may finally terminate in insufficiency of the left ventricle before there is corresponding reduction in the functional capacity of the right ventricle,
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FRED M. SMITH (1937) conducted a review in Left ventricular failure. Left ventricular failure may occur before right ventricular failure, leading to pulmonary congestion and paroxysmal dyspnea, a concept historically described but often overlooked.
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