نظرة عامة
Right-sided heart failure is heart failure that affects the lower right heart chamber, called the right ventricle. Right-sided heart failure makes it hard for the right ventricle to pump blood. When this happens, fluid can build up in the belly, legs and feet.
Right-sided heart failure is common. Proper treatment may improve the symptoms of heart failure and may help some people live longer. But right-sided heart failure can be life-threatening. Some people may need heart transplants or devices to help the heart pump blood.
Right-sided heart failure also may be called right heart failure or right ventricular failure.
Types
There are different types of heart failure. The condition can affect the right or left side of the heart or both.
- Right-sided heart failure. This type affects the lower right heart chamber, called the right ventricle. It can happen because of heart failure on the left side of the heart. Lung disease and pulmonary hypertension also are common causes. Fluid may build up in the belly, legs and feet, causing swelling. The condition is called cor pulmonale when lung disease causes pulmonary hypertension and the right side of the heart becomes larger than usual and does not pump well.
- Left-sided heart failure. This type affects the lower left heart chamber, called the left ventricle. This is the heart's main pumping chamber. Fluid may build up in the lungs, causing shortness of breath. Over time, left-sided heart failure can affect the right side of the heart if pressure in the lungs goes up.
- Heart failure with reduced ejection fraction (HFrEF), also called systolic heart failure. This is a type of left-sided heart failure. The left ventricle doesn't squeeze as strongly as it should, so it pumps less blood.
- Heart failure with preserved ejection fraction (HFpEF), also called diastolic heart failure. This is a type of left-sided heart failure. The left ventricle can't relax or fill as well as it should.
- Heart failure with improved ejection fraction (HFimpEF), formerly called heart failure with recovered ejection fraction (HFrecEF). In this subtype of left-sided heart failure, the ejection fraction was reduced in the past but has improved. This means a low ejection fraction is not always permanent. But heart failure can come back, so treatment usually needs to continue.
الأعراض
If you have right-sided heart failure, your right ventricle doesn't pump blood as well as it should.
Symptoms can develop over time or start suddenly, depending on the cause. Right-sided heart failure symptoms may include:
- Feeling very tired.
- Swelling in the feet, ankles or legs.
- A full or swollen feeling in the belly.
- Reduced ability to exercise.
- Poor appetite or feeling full soon after eating.
- Pain or discomfort in the upper-right part of the belly when the liver is congested.
When to seek care
See your healthcare professional if you think you might have symptoms of heart failure. Call your healthcare professional right away if you have heart failure and:
- Your symptoms suddenly get worse.
- You develop a new symptom.
- You gain 5 pounds (2.3 kilograms) or more in a week.
These changes can mean that heart failure is getting worse or that your treatment isn't working.
When to seek emergency care
Call 911 or your local emergency number if you have:
- Chest pain.
- Fainting or severe weakness.
- A rapid or irregular heartbeat with shortness of breath, chest pain or fainting.
- Sudden, severe shortness of breath or trouble breathing at rest.
These symptoms can have other causes. Don't try to diagnose yourself. Emergency healthcare professionals can do tests to find the cause.
الأسباب
Right-sided heart failure can have many causes. The most common cause is left-sided heart failure. Other causes can raise blood pressure in the lungs, damage the right ventricle or make it work harder.
- Left-sided heart failure. The left ventricle doesn't pump or fill well. Pressure can then build up in the blood vessels in the lungs. This raises pressure in the lungs and makes the right ventricle work harder.
- Pulmonary hypertension. This is high blood pressure in the arteries of the lungs. The higher pressure makes the right ventricle work harder.
- A blood clot in the lung, called pulmonary embolism. A pulmonary embolism is a blood clot that blocks an artery in the lung. It can suddenly increase pressure in the lung and make the right ventricle work harder.
- Coronary artery disease and heart attack. Coronary artery disease can reduce blood flow to the heart and may lead to a heart attack. A heart attack can damage the heart muscle. A heart attack that damages the right ventricle can cause right-sided heart failure.
- Chronic obstructive pulmonary disease or other lung diseases. Long-term lung disease can cause pulmonary hypertension.
- Heart valve disease. Issues with the tricuspid or pulmonary valve can cause right-sided heart failure.
- Disease of the heart muscle, called cardiomyopathy.
Other causes
- Swelling of the heart muscle, called myocarditis.
- Irregular heartbeats, called arrhythmias. Irregular heartbeats may cause the heart to beat too fast, creating extra work for the heart. A slow heartbeat also may lead to heart failure.
- A heart condition that you're born with, called a congenital heart defect. Some heart defects present at birth can make the heart work harder. Over time, this may lead to heart failure.
- Other diseases. Some long-term conditions can contribute to heart failure. These conditions include high blood pressure, obesity, diabetes and thyroid disease. Other conditions that may contribute to heart failure include diseases that cause iron or altered proteins to build up in the heart.
عوامل الخطورة
Some conditions that cause heart failure also increase the risk of developing it. Other risk factors include:
- Age. Getting older increases the chance of heart failure.
- Smoking or using tobacco. Using tobacco increases the risk of heart disease, which can raise the risk of heart failure.
- Heavy alcohol use. Drinking too much alcohol can weaken the heart muscle and lead to heart failure.
- Sleep apnea. Sleep apnea affects breathing during sleep. It can lower oxygen levels in the blood and raise the risk of irregular heartbeats. It's also linked to pulmonary hypertension in some people.
- Some infections. Some infections also can raise the risk of right-sided heart failure. Examples include bacterial endocarditis and some viral infections.
Medicines that may raise the risk of heart failure
- Some diabetes medicines. The diabetes medicine pioglitazone (Actos) can increase the risk of heart failure in some people. Don't stop taking these medicines without first talking with your healthcare professional.
- Some other medicines. Some chemotherapy medicines and cancer treatments may make heart failure worse or damage the heart. Some nonsteroidal anti-inflammatory drugs (NSAIDs) and some medicines to treat heartbeats that are not regular may increase the risk of heart failure. Some medicines used to treat high blood pressure, nervous system diseases, mental health conditions, lung conditions and infections also may increase the risk.
المضاعفات
If you have right-sided heart failure, it's important to have regular health checkups, even if symptoms improve. Your healthcare professional can examine you and do tests to check for complications.
Complications of heart failure depend on your age, overall health and how serious your heart disease is. They may include:
- Kidney damage or failure. Heart failure can reduce blood flow to the kidneys. Untreated, this can cause kidney failure. Kidney damage from heart failure can require dialysis for treatment.
- Irregular heartbeats. Heart failure can raise the risk of irregular heartbeats. Some irregular heartbeats can make heart failure worse. Some types of irregular heartbeats can lead to a life-threatening condition called sudden cardiac arrest.
- Liver damage. Heart failure can cause fluid buildup that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes it harder for the liver to work properly.
- Poor nutrition or digestive issues. Fluid buildup in the stomach and intestines can make you lose your appetite and make it harder for the body to absorb nutrients.
- Sudden cardiac arrest. If the heart is weak, there is a risk of dying suddenly due to a dangerous irregular heart rhythm.