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May 25, 2013
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Right-Sided Heart Failure


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 increasingly difficult for the right ventricle to pump returning blood through the lungs. Like the left ventricle, the right ventricle will eventually weaken and begin 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). While left-sided heart failure is typically the cause of right-sided heart failure, 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 failureThe left ventricle does not pump blood efficiently, leading to pressure buildup behind the left side of the heart that eventually 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 in to the right ventricle, which also eventually fails, allowing blood to then back up farther into the extremities, the liver, and the other organs.
Chronic lung diseaseIncludes emphysema, pulmonary embolism, and other causes of pulmonary hypertensionHigh blood pressure in the pulmonary arteries increases the workload of the right ventricle, eventually causing the right ventricle to fail.
Coronary artery diseaseBlockage of the arteries that supply blood to your heartCAD can cause left-sided heart failure leading to right-sided heart failure or can directly cause right-sided heart failure by blocking blood supply to the right ventricle.
Pulmonic stenosisNarrowing of the pulmonic valve that limits blood flow out of the right ventricleIncreases the work of the right ventricle; similar to chronic lung disease
Tricuspid stenosis Narrowing of the tricuspid valve Limits blood flow out of the right atrium, causing enlargement of the right atrium and backup of blood flowing to it
Tricuspid regurgitationTricuspid valve doesn't close properly, causing blood in the right ventricle to flow back into the right atriumCauses volume overload of the right ventricle, which eventually causes right ventricular dilatation and failure
Pericardial constrictionThe 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 shuntAn abnormal connection between the left and right side of the heart, usually present from birthCauses a volume overload of the right ventricle, similar to tricuspid regurgitation
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