If a person has right sided heart failure, it means the right side of their heart is not pumping blood to the lungs as effectively. The condition can develop if a person has already experienced weakness in the left side of the heart. Experts also refer to right sided heart failure as pulmonary heart disease.
In most cases, right sided heart failure results from problems that have already occurred in the left ventricle. However, it can also develop if a person is experiencing generalized heart failure or lung disease.
Blood can become blocked in the left ventricle and lungs. This puts extra stress on the right ventricle to pump the blood into the lungs. Over time, the right side of the heart can weaken and start to fail.
This article will outline the characteristics of right sided heart failure. It will also discuss its symptoms and causes and treatment options.
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When a person experiences heart failure, it means the heart muscle is not strong or flexible enough to pump blood throughout the body.
The right side of the heart takes deoxygenated blood that has already been through the heart and pumps it out into the lungs. The lungs then replenish it with oxygen.
In right sided heart failure, the right ventricle of the heart is unable to pump enough blood to the lungs.
This often happens due to failure in the left side of the heart. Increased fluid and pressure then pass through the right side of the heart muscle and into the lungs.
Consequently, the right side of the heart becomes weaker and damaged. There is also a buildup of blood in the veins, which can cause dispersion of fluid to surrounding tissues. This in turn can lead to swelling throughout the body, including the:
- legs
- ankles
- abdomen
- gut
- liver
When right sided heart failure occurs, the increased pressure in the veins causes dispersion of fluid to surrounding tissues. This happens because this side of the heart is too weak to pump blood forward to the lungs.
The result may be a buildup of fluid in various parts of the body, including the legs, abdomen, and liver.
By contrast, when left sided heart failure occurs, it means the left ventricle is not pumping enough blood throughout the body. Blood then accumulates in the pulmonary veins, which are blood vessels that carry blood away from the lungs.
When left sided heart failure occurs, a person can experience the following:
- difficulty breathing
- coughing
- shortness of breath
While left sided heart failure is the most common type of heart failure, it can lead to right sided heart failure.
Learn more about left sided heart failure here.
Right sided heart failure can be due to the following conditions:
Left sided heart failure
Left sided heart failure is the primary cause of right sided heart failure.
When the left ventricle is not working as effectively, fluid pressure increases and ends up moving back through the lungs. This can cause an overload to the heart’s right side.
Consequently, when the right side is unable to pump blood, fluid accumulates in the veins, resulting in swelling.
Pulmonary hypertension
Right sided heart failure is the main consequence of pulmonary hypertension, which is when there is high blood pressure in the blood vessels that deliver oxygen-rich blood to the lungs.
If there are changes in the small blood vessels inside the lungs, high blood pressure can occur in the right side of the heart. As a result of the added strain, the heart has difficulty pumping blood to the lungs.
Chronic conditions such as pulmonary embolism and chronic obstructive pulmonary disease (COPD) and diseases that cause difficulty breathing, including chronic bronchitis and emphysema, can cause strain on the right side of the heart.
Congenital heart conditions
Abnormal heart function can result from structural heart conditions that are present at birth. Conditions may include:
- abnormal heart valves
- abnormal blood vessels
- improper formation of the heart
These conditions may affect how blood flows through the heart and to the rest of the body.
Pulmonic stenosis
A person with pulmonic stenosis experiences a narrowing of the pulmonic valve. This decreases blood flow out from the right ventricle, which then needs to work harder.
Similar to chronic lung disease, this extra strain can cause the right ventricle to fail over a period of time.
Other possible causes
Other causes of right sided heart failure include:
- Valvular heart disease: If one of the four heart chambers is damaged, this may prevent the heart from pumping blood the way it should.
- Sleep apnea: People who experience sleep apnea breathe differently when they sleep. This can increase pressure in the left and right ventricles of the heart and lead to right sided heart failure.
- Carcinoid heart disease: Tumors in the heart usually affect the right side. This then can cause right sided heart failure.
To diagnose right sided heart failure, a cardiologist, who specializes in the treatment of disorders of the heart and blood vessels, will perform a thorough exam. This can include a medical history evaluation and other tests, such as:
- Electrocardiogram (EKG): With the help of EKG, doctors can detect elevated pulmonary artery pressure, valvular heart disease, and other conditions affecting the heart.
- Echocardiogram: Sound waves help take moving pictures of the heart and identify how its right side is working.
- Pulmonary function test: This test can verify the presence of COPD and determine its severity.
- Blood tests: Doctors use these to assess the functioning of the liver, kidney, and thyroid. Blood tests can also help detect heart failure and determine whether a substance called brain natriuretic peptide is present.
- Chest X-ray: These scans help determine whether the lungs are congested and whether the heart is enlarged.
- CT scan: CT scans take X-rays of the chest.
- MRI scans: MRI scans use radio waves, magnets, and a computer to create detailed pictures of the heart.
- Cardiac catheterization: Doctors insert a catheter into the right-side ventricle of the heart to measure pressure, or into the coronary arteries to look for blockages in the blood flow to the blood vessels around the heart.
Treatment for right sided heart failure aims to manage symptoms.
Treating risk factors for pulmonary hypertension is an important step toward keeping this condition under control.
Doctors will recommend treatment options depending on the cause of the condition.
Medication
If a person has right sided heart failure, a doctor may need to remove extra sodium and fluid and relax blood vessels. Medications will aim at:
Behavioral changes
A person with a right sided heart failure diagnosis may need to make certain behavioral changes, including:
- avoiding strenuous activity
- avoiding high altitudes
- quitting smoking, if applicable
- limited salt consumption
- reducing intake of fluids
- using oxygen
- avoiding pregnancy
Learn about how to follow a cardiac diet here.
Surgery
If medication and lifestyle changes prove ineffective, a doctor may recommend a transplant of a lung, the heart, or both.
Learn more about organ transplants here.
A person with right sided heart failure will likely need treatment for the rest of their life.
While there is currently no cure, there are steps a person can take to manage symptoms and treat the cause of their heart failure.
Chronic right sided heart failure can be a result of a number of conditions, including left sided heart failure.
A person with a right sided heart failure diagnosis should consult a doctor to find the most suitable management and treatment options. Researchers are working to develop new therapies. However, treatment may last for the rest of a person’s life.
Making lifestyle changes, such as reducing stress and avoiding alcohol, can help reduce symptoms. It is also important to manage contributing health factors, such as blood pressure and anemia.
When your heart is strong, it pumps blood throughout your body. But when you have heart failure, the muscles in your heart walls slowly weaken. Once they’re too weak, your heart can’t pump the blood that your body needs.
And heart failure is so common. It’s one of the main reasons people age 65 and older are admitted to the hospital. It can happen on either the right or left side of your heart. But what difference does it make which side is affected?
When your heart is working normally, it pumps oxygen-rich blood through your lungs and to the rest of your body. The left ventricle, or left chamber, of the heart provides most of the heart’s pumping power. So when you have left-side heart failure, your heart can’t pump enough blood to your body.
The right ventricle, or right chamber, moves “used” blood from your heart back to your lungs to be resupplied with oxygen.
So when you have right-side heart failure, the right chamber has lost its ability to pump. That means your heart can’t fill with enough blood, and the blood backs up into the veins. If this happens, your legs, ankles, and belly often swell.
Sometimes it just happens. But usually it’s left-side heart failure that causes right-side heart failure. As the left chamber of your heart loses some of its ability to pump, blood continues to back up -- sometimes into your lungs.
Heart failure is a long-term condition that gets worse over time. In most cases, you get it because you have other health issues that have damaged or weakened your heart.
Some other causes of right-side heart failure include:
Coronary artery disease. This is the most common form of heart disease and cause of heart failure. When you have coronary artery disease, plaque blocks your arteries, causing blood flow to your heart muscle to slow or even stop. Read more on clogged arteries and the causes of arterial plaque.
High blood pressure. It measures how hard your heart pumps blood through your arteries. The higher your blood pressure, the harder your heart is working to pump it. That means over time, your heart muscles can thicken and weaken because of the extra work they do. Learn about the symptoms of high blood pressure.
Damaged heart valves. Valves keep blood flowing in the right direction through your heart. If they get damaged, by an infection or heart defect, for instance, your heart has to work harder to pump blood. Eventually, it will become weakened. Get more information on heart valve disease symptoms and causes.
Congenital heart defects. Some babies are born with problems in their heart structure. If you were, it could increase your odds of heart failure. Read about the most common congenital heart condition, ventricular septal defect.
Arrhythmia. This is when your heart has an irregular heartbeat. It may beat too fast, too slow, or just not the way it should. Most of the time, arrhythmia is harmless. But it can also make your heart pump an insufficient amount of blood through the body. If it’s not treated, it could weaken your heart over time. View a slideshow on the different causes of heart palpitations.
Lung disease. Over time, problems in the lungs cause the right side of the heart to enlarge and fail. Your doctor may call this “cor pulmonale.” Find out more on the link between heart failure and lung disease.
Other long-term health conditions. Diabetes, HIV, and thyroid problems are examples of health issues that do not go away and eventually could play a part in heart failure.
Your feet, legs, and ankles will likely to swell because blood is backing up in your veins. This symptom is called edema.
- If it backs up into your stomach or liver, you may notice that your abdomen is distended, too.
- You might find that you have to go to the bathroom more, especially at night. This is caused by fluid buildup, too.
As your heart failure gets worse, you may also see some of these symptoms:
- It’s hard to breathe.
- Your neck veins are swollen.
- Your pulse is fast or feels “off.”
- Your chest hurts.
- You’re gaining weight from excess fluid.
- You don’t feel like eating.
- Your skin is cold and sweaty.
- You’re very tired.
- You’re confused and forget things.
There is no cure for heart failure, but there are treatments for its symptoms. Talk to your doctor. They may suggest medications to make you more comfortable. In some cases, a procedure or surgery may be necessary.
Your doctor will also suggest you do some things differently to reduce the stress on your heart. These might include:
- Lose weight, or stay at a weight that feels best.
- Quit smoking.
- Exercise.
- Eat a diet high in lean protein, low-fat dairy, whole grains, fresh fruits, and vegetables.
- Cut back on sodium, saturated fats (found in meats and full-fat dairy products), added sugars, and carbs.
- Get enough rest.
Heart failure happens over time. But if you see your doctor and make some changes, you may stop the damage and get on with living a strong, happy life.