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Acute Left Ventricular Failure (ALVF)

Acute Left Ventricular Failure (ALVF) is a sudden inability of the left ventricle (LV) to pump blood effectively to meet the body's metabolic needs.


  • Leads to:

    • Pulmonary congestion (fluid in lungs)

    • Systemic hypoperfusion (poor blood supply to organs)

    • Potential progression to acute heart failure syndromes or cardiogenic shock


  • Pathophysiology:

    • ā†“ Myocardial contractility (weakened heart muscle)

    • Impaired diastolic filling (stiff ventricle)

    • Acute hemodynamic shifts due to:

      • Ischaemia

      • Arrhythmias

      • Hypertensive crisis

      • Valvular emergencies


Key Causes of Acute Left Ventricular Failure (ALVF)


Cause Mechanism / Impact
Acute Myocardial Infarction (AMI) Myocardial necrosis ā†’ ā†“ Contractility ā†’ Cardiogenic shock
Coronary Artery Disease (CAD) Chronic ischaemia ā†’ Progressive LV dysfunction
Hypertensive Crisis Acute ā†‘ Afterload ā†’ LV strain & decompensation
Valvular Heart Disease Acute MR/AR ā†’ Volume overload ā†’ LV failure
Arrhythmias (AF, VT) Rapid/irregular rhythms ā†’ ā†“ Cardiac Output (CO), dyssynchrony
Stress Cardiomyopathy (Takotsubo) Catecholamine surge ā†’ Transient LV dysfunction
Myocarditis Inflammation ā†’ Direct myocardial injury ā†’ ā†“ Pump function
Decompensated Chronic Heart Failure Worsening of stable CHF due to triggers (e.g., infection, arrhythmia)
Pulmonary Embolism (Massive) Severe hypoxia + RV strain ā†’ ā†“ LV preload
Sepsis / Severe Infections Systemic inflammatory response ā†’ ā†“ Myocardial contractility
Toxins / Drugs Alcohol, cocaine, chemotherapy...

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