Heart failure is a general term for a weakening of the heart muscle that leaves it unable to pump enough blood to meet the demands of the body. There are actually several types of heart failure, each with its own cause and complications.
Right-sided heart failure involves the part of the heart responsible for pumping blood to the lungs, where it receives oxygen. The blood then travels throughout the body to deliver oxygen to your organs, muscles, and other tissues.
While treatment options vary, they usually involve a comprehensive approach to maintaining the health of your entire heart and circulatory system. The outlook for someone with right-sided heart failure depends on the severity of the disease, as well as how early treatment begins.
While it’s sometimes a life threatening condition, it can be managed with a combination of medications, lifestyle changes, and in some cases, surgery.
The term heart failure sounds like the heart has stopped pumping, similar to how the phrase “engine failure” means an engine no longer produces any power.
Heart failure actually means that the heart muscle has grown weaker and can no longer provide sufficient blood flow to all parts of the body. The heart still pumps, just not as efficiently and effectively as it once did.
As a result, the body doesn’t get all the oxygenated blood it needs to function and complications affecting various other organs can develop.
What is left-sided heart failure?
Left-sided heart failure is a more common condition than right-sided heart failure. It happens when the left ventricle has to pump harder than usual to try to deliver enough blood to keep the body healthy.
There are two types of left-sided heart failure:
- heart failure with preserved ejection fraction, meaning the left ventricle can no longer relax enough to fill with the necessary amount of blood in between heartbeats or functions at a much higher pressure
- heart failure with reduced ejection fraction, meaning the left ventricle can’t contract properly and the heart doesn’t have the force needed to pump blood out to the body
Fluid retention causing swelling in the lower limbs and sometimes the abdomen is a common and obvious symptom of right-sided heart failure, but there are several other symptoms that may develop:
Several factors can weaken the heart and trigger heart failure.
Conditions that damage your heart, such as a heart attack, or that make your heart work harder, such as valve disease, can have the same result. Right-sided heart failure can also be brought on by lung disease or pulmonary hypertension.
Right-sided heart failure is most commonly brought on by left-sided heart failure. When the left side of your heart weakens, blood can build up within the chambers. This increases the pressure within the blood vessels carrying blood to the lungs — a condition known as pulmonary hypertension.
To compensate, the right side of the heart must work harder. Eventually, the right side weakens from the extra effort, and you develop right-sided heart failure.
Right-sided heart failure can also be a result of leaky or damaged right-sided valves, such as a leaky tricuspid valve (tricuspid regurgitation).
Specific risk factors for right-sided heart failure include:
- age, as the heart can weaken over time
- family history of heart failure and other heart conditions
- alcohol or drug misuse, smoking, or unbalanced diet
- medical conditions, including cardiovascular disease, hypertension, obesity, sleep apnea, and cancer (because some cancer treatments can injure the heart)
The proper treatment for right-sided heart failure depends on the underlying condition causing it. Treating right-sided heart failure usually involves the use of one or more medications, lifestyle measures, and possibly implanted devices that support the heart’s ability to pump.
The following types of medications are among those commonly prescribed to treat right-sided heart failure:
- Diuretics. Diuretics help rid the body of excess fluid and sodium. Fluid management with diuretics is key to maintaining the right ventricle’s ability to fill with the proper amount of blood for each heartbeat. Special types of diuretics, known as potassium-sparing diuretics, can reduce the loss of potassium caused by fluid reduction.
- Vasodilators. These drugs help blood vessels relax, so the heart doesn’t have to work as hard and interrupt chemicals that weaken the heart. Two widely prescribed vasodilators include angiotensin receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors.
- Beta-blockers. Beta-blockers help slow the heart rate, easing the workload of the heart muscle.
- Digoxin. Digoxin is a drug that helps strengthen the heart’s pumping ability. It’s typically used in more serious cases of heart failure.
- Pulmonary vasodilators. In cases of pulmonary hypertension causing right-sided heart failure, these medications relax the blood vessels going to the lungs to “unload” the heart.
To help your heart work efficiently, the following lifestyle measures are important:
- not smoking
- maintaining your weight — using a home scale may be important to track weight gain caused by fluid retention
- following a balanced, low-sodium diet
- exercising regularly in accordance with a doctor’s advice or with the guidance of a cardiac rehabilitation specialist
For more serious cases of right-sided heart failure, you may need an implanted device to support healthy heart function.
A mechanical heart pump can take the form of a ventricular assist device or a total artificial heart, to compensate for the heart’s loss of pumping strength.
In some cases, surgery may be needed to correct a congenital heart defect that caused the heart failure. Or, in the most serious cases, a heart transplant may be necessary if other treatment options have been unsuccessful.
Right-sided heart failure is a lifelong condition, and there is currently no cure. However, many people manage symptoms and maintain a decent quality of life.
The key is to work closely with your doctor and follow your medication regimen exactly as prescribed.
It’s also critical to report any new symptoms and to manage any other medical conditions that could contribute to or worsen because of heart failure. These may include:
There are advances in mechanical support devices, suggesting that treatment options will continue to save and extend lives.