If a person has right sided heart failure, it means the right side of their heart is not pumping blood to the lungs as effectively. The condition can develop if a person has already experienced weakness in the left side of the heart. Experts also refer to right sided heart failure as pulmonary heart disease.

In most cases, right sided heart failure results from problems that have already occurred in the left ventricle. However, it can also develop if a person is experiencing generalized heart failure or lung disease.

Blood can become blocked in the left ventricle and lungs. This puts extra stress on the right ventricle to pump the blood into the lungs. Over time, the right side of the heart can weaken and start to fail.

This article will outline the characteristics of right sided heart failure. It will also discuss its symptoms and causes and treatment options.

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When a person experiences heart failure, it means the heart muscle is not strong or flexible enough to pump blood throughout the body.

The right side of the heart takes deoxygenated blood that has already been through the heart and pumps it out into the lungs. The lungs then replenish it with oxygen.

In right sided heart failure, the right ventricle of the heart is unable to pump enough blood to the lungs.

This often happens due to failure in the left side of the heart. Increased fluid and pressure then pass through the right side of the heart muscle and into the lungs.

Consequently, the right side of the heart becomes weaker and damaged. There is also a buildup of blood in the veins, which can cause dispersion of fluid to surrounding tissues. This in turn can lead to swelling throughout the body, including the:

  • legs
  • ankles
  • abdomen
  • gut
  • liver

When right sided heart failure occurs, the increased pressure in the veins causes dispersion of fluid to surrounding tissues. This happens because this side of the heart is too weak to pump blood forward to the lungs.

The result may be a buildup of fluid in various parts of the body, including the legs, abdomen, and liver.

By contrast, when left sided heart failure occurs, it means the left ventricle is not pumping enough blood throughout the body. Blood then accumulates in the pulmonary veins, which are blood vessels that carry blood away from the lungs.

When left sided heart failure occurs, a person can experience the following:

While left sided heart failure is the most common type of heart failure, it can lead to right sided heart failure.

Learn more about left sided heart failure here.

A person with isolated right sided heart failure may experience the following:

Right sided heart failure can be due to the following conditions:

Left sided heart failure

Left sided heart failure is the primary cause of right sided heart failure.

When the left ventricle is not working as effectively, fluid pressure increases and ends up moving back through the lungs. This can cause an overload to the heart’s right side.

Consequently, when the right side is unable to pump blood, fluid accumulates in the veins, resulting in swelling.

Pulmonary hypertension

Right sided heart failure is the main consequence of pulmonary hypertension, which is when there is high blood pressure in the blood vessels that deliver oxygen-rich blood to the lungs.

If there are changes in the small blood vessels inside the lungs, high blood pressure can occur in the right side of the heart. As a result of the added strain, the heart has difficulty pumping blood to the lungs.

Chronic conditions such as pulmonary embolism and chronic obstructive pulmonary disease (COPD) and diseases that cause difficulty breathing, including chronic bronchitis and emphysema, can cause strain on the right side of the heart.

Congenital heart conditions

Abnormal heart function can result from structural heart conditions that are present at birth. Conditions may include:

  • abnormal heart valves
  • abnormal blood vessels
  • improper formation of the heart

These conditions may affect how blood flows through the heart and to the rest of the body.

Pulmonic stenosis

A person with pulmonic stenosis experiences a narrowing of the pulmonic valve. This decreases blood flow out from the right ventricle, which then needs to work harder.

Similar to chronic lung disease, this extra strain can cause the right ventricle to fail over a period of time.

Other possible causes

Other causes of right sided heart failure include:

  • Valvular heart disease: If one of the four heart chambers is damaged, this may prevent the heart from pumping blood the way it should.
  • Sleep apnea: People who experience sleep apnea breathe differently when they sleep. This can increase pressure in the left and right ventricles of the heart and lead to right sided heart failure.
  • Carcinoid heart disease: Tumors in the heart usually affect the right side. This then can cause right sided heart failure.

To diagnose right sided heart failure, a cardiologist, who specializes in the treatment of disorders of the heart and blood vessels, will perform a thorough exam. This can include a medical history evaluation and other tests, such as:

  • Electrocardiogram (EKG): With the help of EKG, doctors can detect elevated pulmonary artery pressure, valvular heart disease, and other conditions affecting the heart.
  • Echocardiogram: Sound waves help take moving pictures of the heart and identify how its right side is working.
  • Pulmonary function test: This test can verify the presence of COPD and determine its severity.
  • Blood tests: Doctors use these to assess the functioning of the liver, kidney, and thyroid. Blood tests can also help detect heart failure and determine whether a substance called brain natriuretic peptide is present.
  • Chest X-ray: These scans help determine whether the lungs are congested and whether the heart is enlarged.
  • CT scan: CT scans take X-rays of the chest.
  • MRI scans: MRI scans use radio waves, magnets, and a computer to create detailed pictures of the heart.
  • Cardiac catheterization: Doctors insert a catheter into the right-side ventricle of the heart to measure pressure, or into the coronary arteries to look for blockages in the blood flow to the blood vessels around the heart.

Treatment for right sided heart failure aims to manage symptoms.

Treating risk factors for pulmonary hypertension is an important step toward keeping this condition under control.

Doctors will recommend treatment options depending on the cause of the condition.


If a person has right sided heart failure, a doctor may need to remove extra sodium and fluid and relax blood vessels. Medications will aim at:

Behavioral changes

A person with a right sided heart failure diagnosis may need to make certain behavioral changes, including:

  • avoiding strenuous activity
  • avoiding high altitudes
  • quitting smoking, if applicable
  • limited salt consumption
  • reducing intake of fluids
  • using oxygen
  • avoiding pregnancy

Learn about how to follow a cardiac diet here.


If medication and lifestyle changes prove ineffective, a doctor may recommend a transplant of a lung, the heart, or both.

Learn more about organ transplants here.

A person with right sided heart failure will likely need treatment for the rest of their life.

While there is currently no cure, there are steps a person can take to manage symptoms and treat the cause of their heart failure.

Chronic right sided heart failure can be a result of a number of conditions, including left sided heart failure.

A person with a right sided heart failure diagnosis should consult a doctor to find the most suitable management and treatment options. Researchers are working to develop new therapies. However, treatment may last for the rest of a person’s life.

Making lifestyle changes, such as reducing stress and avoiding alcohol, can help reduce symptoms. It is also important to manage contributing health factors, such as blood pressure and anemia.