Right-Sided Heart Failure

Overview

Right-sided heart failure means that the right side of the heart is not pumping blood to the lungs as well as normal.

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. Right-sided heart failure can happen if there is high blood pressure in the arteries of the lungs. This pressure makes the heart work harder to pump blood through the lungs. Over time, the right ventricle may weaken and not pump blood as well as normal.

What causes it?

The most common cause of right-sided heart failure is actually left-sided heart failure. But other conditions, such as certain lung diseases, can cause the right ventricle to get weaker and not pump blood as well as normal.

Causes of right-sided heart failure

Left-sided heart failure.

Left-sided heart failure causes the left ventricle to pump blood inefficiently. This leads to pressure buildup behind the left side of the heart that, over time, may cause the right side of the heart to weaken. Blood backs up behind the left ventricle into the left atrium, in the lungs, and then eventually into the right ventricle, which may not pump blood as well as normal. This allows blood to then back up farther into the extremities, the liver, and the other organs.

Chronic lung disease.

Chronic lung disease includes chronic obstructive pulmonary disease (COPD), pulmonary embolism, and other causes of pulmonary hypertension. High blood pressure in the pulmonary arteries increases the workload of the right ventricle. Over time, the right ventricle may not pump blood as well as normal.

Heart attack.

A heart attack is a blockage of the arteries that supply blood to your heart. A heart attack can cause left-sided heart failure leading to right-sided heart failure. Or it can directly cause right-sided heart failure by blocking blood supply to the right ventricle.

Pulmonic stenosis.

Pulmonic stenosis is a narrowing of the pulmonic valve. It limits blood flow out of the right ventricle and increases the work of the right ventricle. Over time, this may cause the right ventricle to weaken.

Tricuspid stenosis.

Tricuspid stenosis is a narrowing of the tricuspid valve. This limits blood flow out of the right atrium, causing enlargement of the right atrium and backup of blood flowing to it.

Tricuspid regurgitation.

In tricuspid regurgitation, the tricuspid valve doesn't close properly. This causes blood in the right ventricle to flow back into the right atrium. It causes volume overload of the right ventricle. Over time, this may cause the right ventricle to dilate and weaken.

Pericardial constriction.

The 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.

Congenital heart defects.

Congenital heart defects are structural heart problems that have been present since birth. Certain types of defects can cause abnormal blood flow in the heart. This can weaken the right ventricle.

Related Information

Credits

Current as of: January 10, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
Stephen Fort MD, MRCP, FRCPC - Interventional Cardiology