01 · Heart Failure & Pulmonary Edema — Step 01 of 05 · See it
Two patterns at the bedside
Heart failure shows up as congestion, hypoperfusion, or both. Set the phenotype switches and watch where the problem lands.
Phenotype switcher
Left-sided backward failure
HFrEF — weak squeeze
Systolic contraction is impaired, so ejection falls. Forward failure dominates, with backward congestion as pressures rise.
The left ventricle cannot keep up, so pressure backs up: LV filling pressure → left atrial pressure → pulmonary venous pressure → pulmonary congestion.
Pressure pattern
- ↑ LV filling pressure
- ↑ LA pressure
- ↑ pulmonary venous pressure
Bedside findings
- Dyspnea
- Orthopnea / PND
- Crackles
- Pulmonary edema
- Elevated filling pressures
Why this sign?
Tap any finding to trace the physiology behind it.
Lying flat redistributes fluid centrally and increases venous return
Pulmonary vascular and filling pressures rise
Pulmonary congestion worsens
Dyspnea — relieved by sitting up
That chain is why “orthopnea” appears at the bedside.
Tip: ← → keys move between steps.