Right-Sided Heart Failure

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Topic Overview

Right-sided heart failure means that the right side of the heart is not pumping blood to the lungs as well as normal.

What happens to the heart?

Most people develop heart failure because of a problem with the left ventricle. But reduced function of the right ventricle can also occur in heart failure. As blood begins to back up behind the failing left ventricle and into the lungs, it will become harder for the right ventricle to pump returning blood through the lungs. Like the left ventricle, the right ventricle will weaken with time and start to fail.

What causes it?

The most common cause of right-sided heart failure is actually left-sided heart failure (either systolic or diastolic heart failure). But other conditions, such as certain lung diseases, can cause the right ventricle to fail even when there is no problem with your left ventricle.

Causes of right-sided heart failure

Cause

What is it?

How does it cause right-sided heart failure?

Left-sided heart failure The left ventricle does not pump blood efficiently. This leads to pressure buildup behind the left side of the heart that, over time, causes the right side of the heart to fail. Blood backs up behind the left ventricle into the left atrium, in the lungs, and then eventually into the right ventricle, which also eventually fails. This allows blood to then back up farther into the extremities, the liver, and the other organs.
Chronic lung disease It includes emphysema, pulmonary embolism, and other causes of pulmonary hypertension. High blood pressure in the pulmonary arteries increases the workload of the right ventricle. Over time, this causes the right ventricle to fail.
Coronary artery disease This is blockage of the arteries that supply blood to your heart. CAD can cause left-sided heart failure leading to right-sided heart failure. Or it can directly cause right-sided heart failure by blocking blood supply to the right ventricle.
Pulmonic stenosis This is narrowing of the pulmonic valve that limits blood flow out of the right ventricle. It increases the work of the right ventricle, similar to chronic lung disease.
Tricuspid stenosis This is narrowing of the tricuspid valve. It limits blood flow out of the right atrium, causing enlargement of the right atrium and backup of blood flowing to it.
Tricuspid regurgitation The tricuspid valve doesn't close properly. This causes blood in the right ventricle to flow back into the right atrium. It causes volume overload of the right ventricle. Over time, this causes right ventricular dilatation and failure.
Pericardial constriction The pericardium is a membrane sac around the heart. Repeated or ongoing inflammation of it causes stiffening and thickening and prevents the heart from expanding normally to pump. A thickened pericardium restricts the heart's ability to pump effectively.
Left-to-right shunt This is an abnormal connection between the left and right side of the heart. It is usually present from birth. It causes a volume overload of the right ventricle, similar to tricuspid regurgitation.

Related Information

Credits

ByHealthwise Staff

Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology

Specialist Medical Reviewer Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology

Current as ofFebruary 20, 2015