Left sided heart failure occurs when there is weakness or damage in the left side of the heart. Right sided heart failure develops when there is weakness of the muscles in the right side of the heart. A person may develop one or both types.
Heart failure occurs when the heart muscles cannot pump blood effectively through the body and the tissues do not receive enough oxygen.
This article provides information on left sided and right sided heart failure, the symptoms and causes of each, and how one may affect the other.
It also looks at the risk factors and treatment options and answers some frequently asked questions.
The following table outlines the key differences between left sided and right sided heart failure.
| Left heart failure | Right heart failure | |
|---|---|---|
| Definition | The left ventricle cannot pump blood as it should. This causes blood to build up in the veins of the lungs. | The right ventricle cannot pump blood effectively, which leads to a buildup of fluid that causes swelling in the lower body. |
| Common causes | • heart attack • chronic high blood pressure • arrhythmia • coronary artery disease (CAD) | • left sided heart failure • chronic obstructive pulmonary disease (COPD) • other lung diseases |
| Frequency | Left heart failure is the | Isolated right heart failure is less common. |
| Symptoms | Symptoms typically include congestion in the lungs, which can affect breathing. | Symptoms typically include swelling and fluid retention in the body. |
| Neck vein pressure | A person may have a | Blood pressure in the jugular vein may |
The left ventricle is larger than other chambers of the heart, as it supplies most of the power the heart needs to pump blood. Left heart failure occurs when the left ventricle is unable to pump blood effectively around the body.
There are
- Systolic failure, or heart failure with reduced ejection fraction: In systolic heart failure, the left ventricle cannot contract in the usual manner and the heart cannot pump blood with enough force to propel blood into circulation.
- Diastolic failure, or heart failure with preserved ejection fraction: In diastolic heart failure, the muscles of the left ventricle have stiffened and cannot relax normally and the heart cannot fill with blood between beats.
Symptoms may include:
- shortness of breath
- breathlessness while lying down
- weight gain
- swelling
- low blood pressure
- cough
- fatigue
- exercise intolerance
CAD and high blood pressure are
As the heart pumps, blood returns to the right ventricle through the right atrium. The right ventricle moves the blood back out of the heart to the lungs, where the blood gathers oxygen again.
When the right side of the heart cannot pump blood effectively, blood builds up in the veins. This can lead to swelling, fluid retention, and other symptoms.
Symptoms include:
- fluid retention and swelling, especially in the lower body
- heart palpitations
- shortness of breath
- discomfort in the chest
- weight gain
Conditions that can cause right heart failure
- left heart failure
- COPD
- pulmonary embolism
- acute respiratory distress syndrome
- pulmonary hypertension, or high blood pressure in the blood vessels that supply the lungs
Left heart failure is
When the left ventricle does not work properly, it causes increased fluid pressure through the lungs, which transfers to the right side of the heart.
When the right side of the heart cannot pump blood effectively, blood builds up in the veins. This can cause swelling in the legs, ankles, and abdomen.
Risk factors that may increase a person’s chance of developing heart failure include:
There is no cure for heart failure, but lifestyle changes and treatment with medication and surgery can help improve symptoms and outcomes.
Doctors will also treat any underlying conditions.
According to the
Medication
Medications to treat left heart failure include medications to:
- relax blood vessels, such as angiotensin receptor blockers (ARBs) and ACE inhibitors
- slow the heart rate, such as ivabradine and beta-blockers
- remove excess fluid and salt from the body, such as diuretics, aldosterone antagonists, and SGLT2 inhibitors
- strengthen the heart’s ability to pump blood, such as digoxin
Medications to treat right heart failure include drugs to:
- relax blood vessels, such as ARBs and ACE inhibitors
- remove excess fluid and salt from the body, such as diuretics and aldosterone antagonists
Procedures and surgeries
In severe cases, a person may need surgery to implant a medical device, repair a defect, or conduct a heart transplant.
A person may need the following devices:
- Implantable cardioverter defibrillator: A doctor may implant this device to monitor for dangerous heart rhythms that can cause sudden cardiac arrest.
- Biventricular pacemaker: This implanted device can help both sides of the heart contract at the same time to relieve symptoms of heart failure
- Mechanical heart pump: This may be an artificial heart or a ventricular assist device, which a doctor may implant as a long-term treatment or until a person can receive a heart transplant.
Sometimes surgery to correct congenital heart defects, valve problems, or blocked arteries can help with heart failure. When other treatments have failed, a heart transplant may be necessary.
Lifestyle changes
Changes to a person’s lifestyle that can help treat heart failure include:
- stopping smoking
- reaching or maintaining a moderate weight
- consuming less salt
- exercising regularly
- limiting alcohol consumption
- maintaining a regular sleep schedule
- finding healthy ways to manage stress
- managing contributing risk factors, such as blood pressure
The following are frequently asked questions about left sided and right sided heart failure.
What happens when both sides of the heart fail?
This is called biventricular heart failure.
If both sides of the heart fail, a person
What are the stages of heart failure?
The American College of Cardiology, American Heart Association, and Heart Failure Society of America define
At stage A, a person is at risk of heart failure but does not experience symptoms or dysfunction of the heart’s pumping ability. Related health conditions can affect a person’s risk.
Stage B is pre-heart failure. A person’s heart has structural abnormalities or signs of dysfunction but does not experience symptoms at this stage.
Stage C refers to symptomatic heart failure. At this stage, a person experiences abnormal heart function and symptoms of heart failure.
Stage D refers to advanced heart failure. A person will experience significant symptoms and recurrent hospitalizations that impair quality of life despite treatment.
Heart failure may occur when the heart cannot pump blood forcefully or effectively enough to properly supply the tissues of the body.
Left sided heart failure is more common, and right sided heart failure usually occurs as a result of left sided heart failure.
Certain conditions, such as CAD and high blood pressure, have close links to heart failure. Other risk factors include obesity, diabetes, age, and family history.
Lifestyle strategies such as stopping smoking and maintaining a healthy weight can reduce some risk factors for heart failure.
A doctor may treat heart failure with medications or, in severe cases, surgery.