Heart failure is a general term for the weakening of the heart muscle that leaves it unable to pump enough blood to meet the body’s demands. There are several types of heart failure, each with its own cause and complications.
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.
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. Due to certain conditions, such as left-sided heart failure, the right ventricle may struggle to pump blood effectively to the lungs, weakening it over time.
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 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 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. Still, there are several other symptoms that may develop:
- shortness of breath, especially when lying flat
- difficulty concentrating and confusion
- fatigue and low energy
- sudden weight gain
- reduced appetite
- upset stomach
- change in urination
- edema/abdominal bloating
Left-sided heart failure symptoms
Left-sided heart failure symptoms may look slightly different. Here are some
- shortness of breath
- trouble breathing
- coughing/trouble breathing during physical activity
- shortness of breath during sleep (PND)
When to schedule a medical appointment
If you notice swelling in your ankles, legs, feet, or abdomen, see a doctor. Shortness of breath in any situation is also a symptom that demands medical evaluation.
Swelling, fatigue, and shortness of breath are a few hallmarks of right-sided heart failure, and you shouldn’t ignore them.
Call 911 or visit a local emergency medical center if you notice:
- sudden shortness of breath while also having chest pain or heart palpitations
- coughing up blood-tinged phlegm while also having trouble breathing
- racing or irregular heart rate
Several factors can weaken the heart and trigger heart failure.
Conditions that damage your heart, such as a heart attack, or make your heart work harder, such as valve disease, can have the same result. Right-sided heart failure can also occur due to 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 result from 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 using one or more medications, lifestyle measures, and possibly implanted devices that support the heart’s ability to pump. Treating left-sided heart failure is also important.
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
- limiting fluid intake
- exercising regularly in accordance with a doctor’s advice or with the guidance of a cardiac rehabilitation specialist
For more severe 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 repair the heart valve that is dysfunctional. Or, in the most serious cases, a heart transplant may be necessary if other treatment options have been unsuccessful.
While there are several risk factors that can lead to heart failure, there are still
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 precisely as prescribed.
It’s also critical to report any new symptoms and 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.
How common is right-sided heart failure?
What is the right-sided heart failure life expectancy?
Life expectancy with right-sided heart failure depends on the severity of the disease, your age, and your lifestyle choices. However, the prognosis for right-sided heart failure is typically poor.
Can left sided heart failure cause right-sided heart failure?
Yes, and the two are often linked. Left-sided heart failure results in the left ventricle having to work harder to pump blood effectively to the body — which affects the right ventricle’s ability to pump enough blood into the lungs.
Heart failure is a widespread disease, especially as a person ages.
However, specific steps and lifestyle changes may help prevent heart failure from occurring or minimize the symptoms if it does happen, such as not smoking, managing high blood pressure, and exercising regularly.
Working closely with your doctor and following your medication regimen as prescribed can help extend your life expectancy with right-sided heart failure.