Left-Sided Heart Failure vs. Right-Sided Heart Failure

What is the Difference Between Left and Right-Sided Heart Failure?

Heart failure can occur in the left side of the heart, the right side of the heart or on both sides. The major difference between left-sided heart failure and right-sided heart failure is in the side of the heart that is weakened. In left-sided heart failure, the left side of the heart is weakened and results in reduced ability for the heart to pump blood into the body. In right-sided heart failure, the right side of the heart is weakened and results in fluid in your veins, causing swelling in the legs, ankles, and liver.

To understand these conditions, it is important to know a little about how blood flows through the heart.

The heart is made up of four chambers. The upper chambers are called atria and the lower chambers are called ventricles. Each side of the heart has paired upper and lower chambers. Blood returns from the body and enters the right atrium. From there it moves to the right ventricle, which pumps it to the lungs where it is oxygenated. Blood moves from the lungs into the left atrium, down to the left ventricle and then out to the body to supply organs and tissues with oxygen and nutrients.

Left-Sided Heart Failure

Left-sided heart failure (sometimes referred to as left ventricular or LV heart failure) is the more common of the two types. In this condition, the left ventricle is unable to pump blood out to the body efficiently. This is either because the ventricle can’t exert sufficient force to move the blood or because the ventricle can’t relax properly between beats and allow itself to fill with blood. As a result, blood backs up into the lungs.

What are the symptoms of left-sided heart failure?

• Shortness of breath
• Accumulation of fluid in the lungs

What Causes Left-sided Heart Failure?

Generally, heart failure starts on the left side – specifically, the left ventricle, your heart’s main pumping chamber. Heart failure often occurs after another condition has weakened the heart. Any of the below conditions can weaken the heart and cause heart failure:

• Coronary artery disease and heart attack
• High blood pressure
• Faulty heart valves
• Damage to the heart muscle
• Inflammation of the heart muscle (myocarditis)
• Congenital heart defect (a heart problem you’re born with)
• Abnormal heart rhythms (arrhythmia)
• Diabetes
• HIV
• Over- or underactive thyroid

Right-Sided Heart Failure

Right-sided heart failure (right ventricular or RV heart failure) can be caused by issues like lung disease, but most often it is the result of left-sided heart failure. The accumulation of blood in the lungs forces the right ventricle to be overworked and ultimately fail.

What are the symptoms of right-sided heart failure?

• Swelling in the abdomen (including the liver and gastrointestinal tract)
• Swelling in the legs and ankles

What Causes Right-sided Heart Failure?

Heart failure often occurs after another condition has weakened the heart. Any of the below conditions can weaken the heart and cause heart failure:

• Coronary artery disease and heart attack
• High blood pressure
• Faulty heart valves
• Damage to the heart muscle
• Inflammation of the heart muscle (myocarditis)
• Congenital heart defect (a heart problem you’re born with)
• Abnormal heart rhythms (arrhythmia)
• Diabetes
• HIV
• Over- or underactive thyroid

Does Left-Sided Heart Failure Lead To Right-Sided Heart Failure?

Left-sided heart failure occurs when the left ventricle of the heart is weakened and cannot as efficiently pump blood into the body. As a result of the diminished ejection fraction, fluid can flow back into the lungs and put additional stress on the right side of the heart. This can lead to right-sided heart failure.

Heart Failure Symptoms and Diagnosis

In addition to the symptoms noted above, left-sided and right-sided heart failure can cause:

• Rapid weight gain
• A persistent cough
• Fatigue
• Heart palpitations
• Protruding neck veins
• Irregular pulse

Doctors typically use a physical exam and a procedure called an echocardiogram to diagnose heart failure. The echocardiogram produces detailed images of the heart that the doctor reviews to assess the damage to the heart.

Left-Sided and Right-Sided Heart Failure Treatments

When heart failure is caught in the early stages, it is generally treated with medication. Different drugs are used to help the heart beat more effectively, lower cholesterol, prevent blood clots, slow the heart rate, help the body remove sodium and increase its potassium level as needed. People with heart failure must only take medication approved by their doctor. This includes over-the-counter medications.

In some cases, heart failure reaches a point where surgery is necessary. This can include coronary bypass surgery in which a section of a healthy artery is used to bypass a blocked blood vessel. A procedure called angioplasty may be used in other instances. It involves inserting a small balloon into a narrowed artery and inflating the balloon to widen it. The doctor may then insert a tube called a stent to ensure the artery remains expanded.

When all other treatments have failed, a heart transplant may be performed. This involves removing part or all of the heart and replacing it with a donor heart.

Learn more about the signs of right sided heart failure vs left, and different types of heart failure, including symptoms and treatment options, by visiting Baptist Health Heart Care and finding a provider.