Right-sided heart failure develops when the right side of the heart does not pump blood as well as it should be, causing blood to back up into the venous system and limiting how much blood the heart can pump per minute. Symptoms of right-sided heart failure, such as dyspnea (shortness of breath), edema (swelling of the limbs), and fatigue can be severe. There are a multitude of reasons the right side of the heart might become weak and so treatment, which can include lifestyle changes and medication, is determined based on the cause. Show
Anatomy of the HeartThe heart is made up of four chambers. The upper chambers are called the left and right atria, and the lower chambers are called the left and right ventricles. A wall of muscle called the septum separates the left and right atria and the left and right ventricles. The job of the heart's left ventricle is to pump blood out of the heart to all organs of the body against relatively high pressure, requiring the walls of the left ventricle to be muscular, thick, and strong. By contrast, the right ventricle’s job is to pump “used,” oxygen-poor blood to the lungs via the pulmonary artery to be replenished with oxygen. It can work under low pressure, and is a relatively thin-walled structure, with much less cardiac muscle than the left ventricle. SymptomsThe symptoms of right-sided heart failure aren't dissimilar to those of left-sided heart failure, but they can be more severe:
Right-sided heart failure:
Left-sided heart failure:
CausesThe conditions that cause predominantly right-sided heart failure are different from those known to cause predominantly left-sided heart failure and fall into three categories. Pulmonary HypertensionPulmonary hypertension is elevated blood pressure in the pulmonary artery. It can lead to right-sided heart failure because the walls of the right side of the heart are thin and relatively inefficient at pumping under conditions of high pressure. If the right ventricle has to work for extended periods of time against elevated pressures in the pulmonary artery, it begins to fail. Pulmonary hypertension associated with right-sided heart failure can develop due to:
Other potential causes of pulmonary hypertension include primary pulmonary hypertension, scleroderma, sarcoidosis, or various forms of vasculitis affecting the lungs. Right-sided heart failure that is not caused by cardiac disease involving the left side of the heart is almost always due to a lung disorder that produces pulmonary hypertension. Right-sided heart failure that is secondary to a pulmonary condition is called cor pulmonale. Valvular Heart DiseaseAny type of valvular heart disease whose chief effect is to increase the pressure within the right side of the heart or to obstruct the flow of blood through the right side of the heart can produce right-sided heart failure. This might include:
Right Ventricular Myocardial InfarctionPeople who have a myocardial infarction (heart attack) caused by a blockage in the right coronary artery may suffer from damage to the right ventricular muscle, producing right-sided heart failure. Treating a right ventricular heart attack is similar to treating any myocardial infarction, including rapidly opening up the blocked blood vessel with “clot-busting” drugs or a stent. However, because right-sided heart failure can limit the amount of blood that reaches the left side of the heart, drugs aimed mainly at treating left-sided ventricular weakness (such as nitrates, beta blockers, and calcium channel blockers) need to be used with great caution in people having right ventricular heart attacks. DiagnosisDiagnosis of right-sided heart failure typically requires a thorough physical examination by a cardiologist as well as medical history and any of a variety of tests. When reviewing health history, they will be especially suspicious of heart failure if you have had deep venous thrombosis or pulmonary embolus. Tests used to diagnose right-sided heart failure include:
Heart Failure Doctor Discussion GuideGet our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Thank you, {{form.email}}, for signing up. There was an error. Please try again. TreatmentAdequate treatment of right-sided heart failure relies on identifying and treating the underlying cause:
While the underlying disease process is being identified, medications may be prescribed, including:
Although a last resort, right-sided heart failure is sometimes treated with a heart transplant, in which the damaged heart is surgically removed and replaced with a healthy heart from a deceased donor. CopingIf you've been diagnosed with heart failure, it's important to be proactive in the management of your condition. In some cases, medication adjustments and lifestyle changes may be enough to help address symptoms. :
A Word From VerywellThe prognosis for recovery from right-sided heart failure depends on the cause of the condition and severity of the symptoms. Although some people can improve with treatment and lifestyle changes, others may require an implant or heart transplant. Because this is a serious condition that can even lead to premature death, it's critical that you receive a thorough medical evaluation when you experience symptoms, and that you act quickly to reverse or ameliorate the underlying cause.
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Richard N. Fogoros, MD Thanks for your feedback! What are significant signs of rightAbnormal heart sounds. Bluish skin. Liver swelling. Swelling of the neck veins, which is a sign of high pressure in the right side of the heart.
What is the most common symptom of right heart failure?Heart failure signs and symptoms may include:. Shortness of breath with activity or when lying down.. Fatigue and weakness.. Swelling in the legs, ankles and feet.. Rapid or irregular heartbeat.. Reduced ability to exercise.. Persistent cough or wheezing with white or pink blood-tinged mucus.. Swelling of the belly area (abdomen). Which findings will the nurse likely observe when a patient has rightShortness of breath (dyspnea), even after only a small amount of exertion. Weakness and lethargy. Fatigue. Swelling (edema), that often involves not only the ankles and lower extremities but also the thighs, abdomen, and chest.
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