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 aged 65 or 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?
Right-Sided vs. Left-Sided Heart Failure
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-sided 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-sided 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. You may also see swelling in the vein that runs down the neck (jugular venous distension).
Right-Sided Heart Failure Causes
Sometimes, it just happens. But usually, it’s left-sided heart failure that causes right-sided 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-sided 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 (for instance, by an infection or heart defect), 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 born like that, it could raise 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 not enough 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 get bigger 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.
Right-Sided Heart Failure Symptoms
Your feet, legs, and ankles will likely 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.
Treatment for Right-Sided Heart Failure
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 lower the stress on your heart. These might include:
- Losing weight or staying at a weight that feels best
- Quitting smoking
- Exercising
- Eating a diet high in lean protein, low-fat dairy, whole grains, fresh fruits, and vegetables
- Cutting back on sodium, saturated fats (found in meats and full-fat dairy products), added sugars, and carbs
- Getting enough rest
Heart failure happens over time. But if you see your doctor and make some changes, you may be able to slow its progression and manage the symptoms in order to maintain a decent quality of life.
Right-Sided Heart Failure: FAQs
What happens if the right side of the heart fails?
When the right side of your heart fails, the right chamber loses its ability to pump well. This means your heart can’t fill with enough blood, and the blood backs up into the veins throughout your body. As a result, you’ll typically have swelling in your legs, ankles, and belly as fluid builds up in these areas.
What are the complications of right-sided heart failure?
The main problems include:
- Edema (swelling in the feet, legs, and ankles due to blood backing up in veins)
- Abdominal distension (swelling in the stomach or liver area)
- Increased urination, especially at night (caused by fluid buildup)
- Breathing trouble as the condition progresses
- Weight gain from too much fluid retention
- Loss of appetite
- Fatigue and confusion
What are two signs of worsening heart failure?
Two key signs that heart failure is getting worse are:
- Trouble breathing, which indicates the heart is struggling more to pump well
- Rapid weight gain from excess fluid, which shows fluid is building up more significantly in your body
Additional warning signs include swollen neck veins, fast or irregular pulse, chest pain, and increased confusion or memory problems.
What medication is used for right-sided heart failure?
Doctors may suggest medications to make patients more comfortable and treat symptoms, though specific medications vary by individual case. Treatment methods focus on symptom management, as there is no cure for heart failure. In some cases, procedures or surgery may also be necessary alongside medication.
What are the final stages of right-sided heart failure?
Heart failure is described as a long-term condition that gets worse over time, though specific final stages aren’t detailed. As heart failure gets worse, symptoms become more serious and may include many problems, such as trouble breathing, significant fluid retention, fatigue, confusion, and other systemic effects.
What is the prognosis for right-sided heart failure?
While heart failure is a long-term condition that worsens over time, there is hope for improvement — because heart failure happens over time. So, if you see your doctor and make some changes, you may be able to slow its progression and manage the symptoms in order to maintain a decent quality of life. The outlook can be improved through medical care and lifestyle changes, including managing weight, quitting smoking, exercising, following a proper diet, and taking enough rest.
