What Is Right-side Heart Failure?

Medically Reviewed by James Beckerman, MD, FACC on March 08, 2023
4 min read

When your heart is strong, it pumps blood throughout your body. But when you have heart failure, the muscles in your heart walls slowly weaken. Once they’re too weak, your heart can’t pump the blood that your body needs.

And heart failure is so common. It’s one of the main reasons people age 65 and older are admitted to the hospital. It can happen on either the right or left side of your heart. But what difference does it make which side is affected?

When your heart is working normally, it pumps oxygen-rich blood through your lungs and to the rest of your body. The left ventricle, or left chamber, of the heart provides most of the heart’s pumping power. So when you have left-side heart failure, your heart can’t pump enough blood to your body.

The right ventricle, or right chamber, moves “used” blood from your heart back to your lungs to be resupplied with oxygen.

So when you have right-side heart failure, the right chamber has lost its ability to pump. That means your heart can’t fill with enough blood, and the blood backs up into the veins. If this happens, your legs, ankles, and belly often swell.

Sometimes it just happens. But usually it’s left-side heart failure that causes right-side heart failure. As the left chamber of your heart loses some of its ability to pump, blood continues to back up -- sometimes into your lungs.

Heart failure is a long-term condition that gets worse over time. In most cases, you get it because you have other health issues that have damaged or weakened your heart.

Some other causes of right-side heart failure include:

Coronary artery disease. This is the most common form of heart disease and cause of heart failure. When you have coronary artery disease, plaque blocks your arteries, causing blood flow to your heart muscle to slow or even stop. Read more on clogged arteries and the causes of arterial plaque.

High blood pressure. It measures how hard your heart pumps blood through your arteries. The higher your blood pressure, the harder your heart is working to pump it. That means over time, your heart muscles can thicken and weaken because of the extra work they do. Learn about the symptoms of high blood pressure.

Damaged heart valves. Valves keep blood flowing in the right direction through your heart. If they get damaged, by an infection or heart defect, for instance, your heart has to work harder to pump blood. Eventually, it will become weakened. Get more information on heart valve disease symptoms and causes.

Congenital heart defects. Some babies are born with problems in their heart structure. If you were, it could increase your odds of heart failure. Read about the most common congenital heart condition, ventricular septal defect.

Arrhythmia. This is when your heart has an irregular heartbeat. It may beat too fast, too slow, or just not the way it should. Most of the time, arrhythmia is harmless. But it can also make your heart pump an insufficient amount of blood through the body. If it’s not treated, it could weaken your heart over time. View a slideshow on the different causes of heart palpitations.

Lung disease. Over time, problems in the lungs cause the right side of the heart to enlarge and fail. Your doctor may call this “cor pulmonale.” Find out more on the link between heart failure and lung disease.

Other long-term health conditions. Diabetes, HIV, and thyroid problems are examples of health issues that do not go away and eventually could play a part in heart failure.

Your feet, legs, and ankles will likely swell because blood is backing up in your veins. This symptom is called edema.

  • If it backs up into your stomach or liver, you may notice that your abdomen is distended, too.
  • You might find that you have to go to the bathroom more, especially at night. This is caused by fluid buildup, too.

As your heart failure gets worse, you may also see some of these symptoms:

 

  • It’s hard to breathe.
  • Your neck veins are swollen.
  • Your pulse is fast or feels “off.”
  • Your chest hurts.
  • You’re gaining weight from excess fluid.
  • You don’t feel like eating.
  • Your skin is cold and sweaty.
  • You’re very tired.
  • You’re confused and forget things.

There is no cure for heart failure, but there are treatments for its symptoms. Talk to your doctor. They may suggest medications to make you more comfortable. In some cases, a procedure or surgery may be necessary.

Your doctor will also suggest you do some things differently to reduce the stress on your heart. These might include:

 

  • Lose weight, or stay at a weight that feels best.
  • Quit smoking.
  • Exercise.
  • Eat a diet high in lean protein, low-fat dairy, whole grains, fresh fruits, and vegetables.
  • Cut back on sodium, saturated fats (found in meats and full-fat dairy products), added sugars, and carbs.
  • Get enough rest.

 

Heart failure happens over time. But if you see your doctor and make some changes, you may stop the damage and get on with living a strong, happy life.