What Are The Causes
Sometimes it just happens. But usually itâs 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.
Myocytes And Myocardial Remodeling
In the failing heart, increased myocardial volume is characterized by larger myocytes approaching the end of their life cycle. As more myocytes drop out, an increased load is placed on the remaining myocardium, and this unfavorable environment is transmitted to the progenitor cells responsible for replacing lost myocytes.
Progenitor cells become progressively less effective as the underlying pathologic process worsens and myocardial failure accelerates. These featuresnamely, the increased myocardial volume and mass, along with a net loss of myocytesare the hallmark of myocardial remodeling. This remodeling process leads to early adaptive mechanisms, such as augmentation of stroke volume and decreased wall stress and, later, to maladaptive mechanisms such as increased myocardial oxygen demand, myocardial ischemia, impaired contractility, and arrhythmogenesis.
As heart failure advances, there is a relative decline in the counterregulatory effects of endogenous vasodilators, including nitric oxide , prostaglandins , bradykinin , atrial natriuretic peptide , and B-type natriuretic peptide . This decline occurs simultaneously with the increase in vasoconstrictor substances from the RAAS and the adrenergic system, which fosters further increases in vasoconstriction and thus preload and afterload. This results in cellular proliferation, adverse myocardial remodeling, and antinatriuresis, with total body fluid excess and worsening of heart failure symptoms.
Shortness Of Breath While Lying Flat And With Exertion
Shortness of breath while lying flat. People who have left heart failure may experience shortness of breath when lying flat . The person will start using two or three pillows to prop themselves up while in bed so that they can breathe easier. If the shortness of breath is more severe, the person may begin sleeping in a chair or recliner.
Shortness of breath with exertion. Shortness of breath with exertion is referred to as dyspnea on exertion. Dyspnea on exertion occurs because the lungs cannot supply enough oxygen and the heart cannot adequately pump oxygen-rich blood to the body. Initially, the shortness of breath may occur when walking long distances or up flights of stairs, but as the heart failure progresses, less activity may produce more symptoms.
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How Common Is Right
More than 6 million Americans have heart failure. Each year, more than 900,000 people receive a heart failure diagnosis.
Heart failure is rare in people younger than 50. With age, it becomes increasingly common. Studies have shown that around 2% of the population younger than 54 years old have heart failure. The number increases to around 8% about 1 in 12 for people over 75.
Right Sided Heart Failure
When the heart is unable to pump blood adequately to meet the demand of the body, it is referred to as heart failure. It affects all the body functions since their requirement of blood is not met. Various conditions collectively cause heart failure and also cause the weakening of the heart. The right or left side of the heart can be affected by heart failure, or sometimes both. It is a chronic condition in any case. We will look at what is right sided heart failure here.
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Whats The Outlook For People With Right
For many people, the right combination of therapies and lifestyle changes can slow or stop the disease and improve symptoms. They can lead full, active lives.
About 1 in 10 American adults who live with heart failure have advanced heart failure. That means treatments arent working, and symptoms are getting worse. You may feel symptoms, such as shortness of breath, even when youre sitting. If you have advanced heart failure, talk with your care team about important care decisions and next steps.
Fatigue And Exercise Intolerance
Persons with heart failure may also notice fatigue and the decreased ability to perform activities or exercise. These complaints tend to be progressive and often arise slowly, so that the person may not be aware of the gradual change in exercise function until daily activities become a chore.
When both the right and left sides of the heart fail to pump adequately, the symptoms and signs of both right and left heart failure develop. The person may complaint of swelling in the legs and feet as well as shortness of breath.
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Left Sided Heart Failure
primary cause of right sided heart failure.
When the left ventricle is not working as effectively, fluid pressure increases and ends up moving back through the lungs. This can cause an overload to the heartâs right side.
Consequently, when the right side is unable to pump blood, fluid accumulates in the veins, resulting in swelling.
What Can I Do To Manage Swelling From Extra Fluid
- Elevate your legs above the level of your heart. This will help with fluid that builds up in your legs or ankles. Elevate your legs as often as possible during the day. Prop your legs on pillows or blankets to keep them elevated comfortably. Try not to stand for long periods of time during the day. Move around to keep your blood circulating.
- Limit sodium . Ask how much sodium you can have each day. Your healthcare provider may give you a limit, such as 2,300 milligrams a day. Your provider or a dietitian can teach you how to read food labels for the number of mg in a food. He or she can also help you find ways to have less salt. For example, if you add salt to food as you cook, do not add more at the table.
- Drink liquids as directed. You may need to limit the amount of liquid you drink within 24 hours. Your healthcare provider will tell you how much liquid to have and which liquids are best for you. He or she may tell you to limit liquid to 1.5 to 2 liters in a day. He or she will also tell you how often to drink liquid throughout the day.
- Weigh yourself every morning. Use the same scale, in the same spot. Do this after you use the bathroom, but before you eat or drink. Wear the same type of clothing each time. Write down your weight and call your healthcare provider if you have a sudden weight gain. Swelling and weight gain are signs of fluid buildup.
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Systolic And Diastolic Failure
Systolic and diastolic heart failure each result in a decrease in stroke volume. This leads to activation of peripheral and central baroreflexes and chemoreflexes that are capable of eliciting marked increases in sympathetic nerve traffic.
Although there are commonalities in the neurohormonal responses to decreased stroke volume, the neurohormone-mediated events that follow have been most clearly elucidated for individuals with systolic heart failure. The ensuing elevation in plasma norepinephrine directly correlates with the degree of cardiac dysfunction and has significant prognostic implications. Norepinephrine, while directly toxic to cardiac myocytes, is also responsible for a variety of signal-transduction abnormalities, such as downregulation of beta1-adrenergic receptors, uncoupling of beta2-adrenergic receptors, and increased activity of inhibitory G-protein. Changes in beta1-adrenergic receptors result in overexpression and promote myocardial hypertrophy.
Diagnosis Of Heart Failure Congestive In Dogs
The veterinarian will physically examine your dog. A heart murmur may be audible through a stethoscope and the veterinarian may even be able to tell which valve is affected based on the placement of the murmur. This, along with other symptoms like fluid accumulation in the abdomen or legs can suggest the problem is located on the right side of the heart. Right-sided CHF is a symptom rather than a disease, so the veterinarian will need to diagnose the underlying condition that is causing your dogs heart to fail. The most common problem is some degree of backflow, or regurgitation in the tricuspid valve that connects the right atrium and ventricle. This could be caused by an inherited condition, age related degeneration, a cancerous tumor, or a heart infection .
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What Raises My Risk For Heart Failure
Many things can raise your risk of heart failure. Some things you can control, such as your lifestyle habits, but many others are out of your control, including your age, race, or ethnicity. Your risk of heart failure goes up if you have more than one of the following.
Heart failure is common in both men and women, although men often develop heart failure at a younger age than women. Women more commonly have heart failure with preserved ejection fraction , which is when the heart does not fill with enough blood. Men are more likely to have heart failure with reduced ejection fraction , . Women often have worse symptoms than men.
Heart Failure With Preserved Ejection Fraction
In diastolic heart failure , the same pathophysiologic processes occur that lead to decreased cardiac output in systolic heart failure, but they do so in response to a different set of hemodynamic and circulatory environmental factors that depress cardiac output.
In HFpEF, altered relaxation and increased stiffness of the ventricle occur in response to an increase in ventricular afterload . The impaired relaxation of the ventricle then leads to impaired diastolic filling of the left ventricle .
Morris et al found that right venticular subendocardial systolic dysfunction and diastolic dysfunction, as detected by echocardiographic strain rate imaging, are common in patients with HFpEF. This dysfunction is potentially associated with the same fibrotic processes that affect the subendocardial layer of the LV and, to a lesser extent, with RV pressure overload. It may play a role in the symptomatology of patients with HFpEF.
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Outlook For Heart Failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities you’re able to do and is often eventually fatal.
But it’s very difficult to tell how the condition will progress on an individual basis.
It’s very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
Causes Of Heart Failure
Heart failure is often the result of a number of problems affecting the heart at the same time.
Conditions that can lead to heart failure include:
- coronary heart disease where the arteries that supply blood to the heart become clogged up with fatty substances , which may cause angina or a heart attack
- high blood pressure this can put extra strain on the heart, which over time can lead to heart failure
- conditions affecting the heart muscle
- heart rhythm problems , such as atrial fibrillation
- damage or other problems with the heart valves
- congenital heart disease birth defects that affect the normal workings of the heart
Sometimes obesity, anaemia, drinking too much alcohol, an overactive thyroid or high pressure in the lungs can also lead to heart failure.
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How Is Heart Failure Treated
Your healthcare providers will help you manage any other health conditions that may be causing your heart failure. The goals of treatment are to manage, slow, or reverse heart damage. Treatment may include the following:
- Medicines may be given to help regulate your heart rhythm and lower your blood pressure. You may also need medicines to help decrease extra fluid. Medicines, such as NSAIDs, may be stopped if they are making your heart failure worse. Do not stop any of your medicines on your own.
- Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. In the program you will learn about exercise, relaxation, stress management, and heart-healthy nutrition. Cardiac rehab may be recommended if your heart failure is not severe.
- Oxygen may help you breathe easier if your oxygen level is lower than normal. A CPAP machine may be used to keep your airway open while you sleep.
- Surgery can be done to implant a pacemaker or another device in your chest to regulate your heart rhythm. Other types of surgery can open blocked heart vessels, replace a damaged heart valve, or remove scar tissue.
Surgery And Other Procedures
If medications are not effective in managing right-sided heart failure, or if symptoms are severe, a ventricular-assist device implant or a heart transplant, may be necessary.
- Ventricular assist device surgery: This device can be implanted to help a weak heart pump more efficiently.
- Heart transplant surgery: This surgery is done when all other right-sided heart failure treatments have failed. The damaged heart is surgically removed and replaced with a healthy heart from a deceased donor.
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What Are Compression Socks
- Compression stockings are specially made, snug-fitting, stretchy socks that gently squeeze your leg.
- Graduated compression or pressure stockings are tighter around your ankle and get looser as they move up your leg.
- Compression sleeves are just the tube part, without the foot.
- Pressure from compression socks helps the blood vessels work better in the legs. This allows the arteries that take oxygen-rich blood to the muscles can relax, so blood flows freely. The veins get a boost pushing blood back to the heart.
- Compression stockings are a worm for comfort, to help prevent serious medical conditions, and compete better in sports.
- Compression stockings can:
- Lower the chances of getting a blood clot in the leg
- Lessen pain and leg swelling
People should who wear compression socks include:
- People with or at risk for circulation problems, like blood clots in the leg , varicose veins, or diabetes
- People who have just had surgery
- People who can’t leave their bed or have a hard time moving their legs
- People who stand all day at work
- Athletes
Pleural Effusion And Paroxysmal Nocturnal Dyspnea
Pleural effusions. Pleural effusions may develop, increasing the severity of shortness of breath.
Dyspnea .
- Heart failure can cause a person to suddenly waken in the middle of the night with the sensation of shortness of breath, suffocating, and wheezing.
- The person may need to sit at the edge of the bed to catch his or her breath, and sometimes, feel the need to get up and go to an open window to get more air.
- Standing or sitting up tends to resolve the shortness of breath after many minutes.
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About Heart And Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.
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Right Sided Vs Left Sided Heart Failure
When right sided heart failure occurs, the increased pressure in the veins causes dispersion of fluid to surrounding tissues. This happens because this side of the heart is too weak to pump blood forward to the lungs.
The result may be a buildup of fluid in various parts of the body, including the legs, abdomen, and liver.
When left sided heart failure occurs, a person
Right sided heart failure can be due to the following conditions:
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Treatment Of Heart Failure Congestive In Dogs
Dogs with moderate to severe problems may need to be hospitalized until the condition is stabilized. Taps will be inserted to remove fluid from the abdomen and around the heart . Strong diuretics, such as furosemide, may be injected to further encourage fluid elimination, and dogs may need additional oxygen.
Once the immediate attack is stabilized, long-term medications will be prescribed to help to control symptoms. Diuretics and ace inhibitors are the most common medications used to reduce fluid build-up and improve blood flow. Pimobendan can increase the force of the hearts contractions, and digoxin may be prescribed if your dogs heart rate is very fast. Beta-blockers and calcium blockers could also be suggested depending on your dogs condition. Most treatment plans will combine a number of different medications.
Other treatment will focus on eliminating the problem that is causing CHF. If your dog has heartworm, it can be treated with medication once your dogs symptoms are stabilized. Some conditions, like atrial septal defect, can be treated with surgery. Others cannot. Valve replacement is only done very rarely in dogs, so problems that affect the valves are often only untreatable symptomatically.
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