Right-sided heart failure

Causes and Risks:
Heart failure may affect the right side, left side, or both sides of the heart. As pumping action is lost on the right side of the heart, blood may back up into other areas of the body including the liver, gastrointestinal tract, and extremities. The heart may be unable to pump blood efficiently to the lungs.

Causes of right-sided heart failure include left-sided heart failure and chronic lung diseases such as emphysema . Other causes include congenital heart disease , heart-valve disease, and cardiomyopathy . When an individual is predisposed to heart failure, anything that puts additional efforts on the heart may precipitate acute symptoms. Precipitating factors include increased activity, increased fluids, high salt intake, high fever or complicated infections, anemia , irregular heartbeats ( arrhythmias ), hyperthyroidism , kidney disease , medications that affect contraction of the heart muscle (such as beta-blockers and calcium channel blockers), and stopping some medications (diuretics, digoxin, ACE inhibitors). Other risk factors include smoking , obesity , and excess alcohol consumption .

Right sided heart failure occurs in approximately 5 out of 100 people.

Prevention:
Follow the provider's advice for treatment of conditions that may cause congestive heart failure . Follow dietary guidelines. Minimize or eliminate smoking and alcohol consumption .

Symptoms:



Signs and Tests:
A physical examination may reveal an irregular or rapid heartbeat . There may be weight gain , distended neck veins, an enlarged liver , and ankle edema . Examination of the chest with a stethoscope ( auscultation ) may reveal lung crackles (occasionally) or abnormal heart sounds .



Treatment:
The goals of treatment include the reduction of cardiac work load, control of symptoms, and improvement of heart function.

Heart failure requires monitoring of the condition by the health care provider. Hospitalization may be required if the symptoms are severe or unstable or there is failure to respond to initial treatment. The underlying disorders and precipitating factors should be treated if possible. This may require medications, surgery, or behavior modification.

Bedrest or reduced physical activity may be recommended to minimize the heart's work load. Decreased dietary sodium (salt) may be recommended. Decreased fluid intake may be recommended.

Vasodilator medications such as captopril, enalapril, and hydralazine may be used to reduce the heart's work load. Diuretic medications may be used to reduce fluid accumulation. This includes loop diuretics (such as furosemide and bumetanide) for moderate symptoms, thiazide diuretics (such as hydrochlorothiazide, chlorthalidone, and chlorothiazide) for mild symptoms, and combination diuretics. Digitalis may be prescribed to increase the muscle contraction of the heart.

Long term recommendations may include:



Prognosis:
Heart failure is a serious disorder that carries a possibility of reduced life expectancy. There is no cure, but many forms of heart failure are well controlled with medication and correction of the underlying disorders. It may take the form of a chronic illness. Heart failure worsens with an infection or other physical stressors.

Complications:



Call Your Healthcare Provider:
Call your health care provider if symptoms indicate congestive heart failure may be present.

Call your health care provider if symptoms change, worsen, or do not improve with treatment.

Also call if chest pain , weakness , fainting , rapid or irregular heartbeat , sudden weight gain or swelling , or other new or unexplained symptoms develop.


This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.



This is an illustration of the exterior of the heart. The arteries are colored blue and represent blood that is flowing into the heart. The veins are red and indicate blood flow out from the heart. The chambers are also labeled.