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Alternative names Return to top
Congestive heart failure - rightDefinition Return to top
Right-sided heart failure is a disorder in which the right side of the heart loses its ability to pump blood efficiently, which is often a complication of other conditions.Causes, incidence, and risk factors Return to top
Heart failure may affect the right side, the left side, or both sides of the heart. In right-sided heart failure, the right side of the heart loses its pumping action and blood may back up into other areas of the body, producing congestion. Congestion affects the liver, the gastrointestinal tract, and the limbs.
In addition, the heart may be unable to pump blood efficiently to the lungs.
Causes of right-sided heart failure include left-sided heart failure and chronic lung diseases (such as emphysema). Other causes include congenital heart disease, primary pulmonary hypertension (PPH), and heart valve disease.
Right-sided heart failure occurs in approximately 5 out of 100 people.
Symptoms Return to top
When an individual is predisposed to heart failure, sudden symptoms may be caused by any factors that impose additional demands on the heart. These factors include the following:
Heart function may also worsen if you stop taking medications used to treat heart failure, such as diuretics, digoxin, ACE inhibitors, or vasodilators.
Signs and tests Return to top
Your health care provider will obtain your medical history and will conduct a physical examination. The examination may reveal the following:
Examination of the chest with a stethoscope may reveal abnormal lung sounds or abnormal heart sounds.
You may be asked to undergo some diagnostic tests:
Treatment Return to top
Heart failure requires periodic monitoring by your health care provider. The goals of treatment include reduction of the cardiac workload, control of symptoms, and improvement of heart function. Any underlying disorders and precipitating factors should be treated, if possible
One frequent recommendation in heart failure is to decrease both the amount of dietary sodium (salt in your food) and your intake of fluids.
Specific therapies for right-sided heart failure depend on the cause of the heart failure and may include the following:
Medications that reduce your heart's workload include angiotensin converting enzyme (ACE) inhibitors (such as captopril or enalapril), angiotensin receptor blockers (such as losartan or candesartan), and vasodilators such as hydralazine and long-acting nitrates. Beta-blockers (such as metoprolol or carvedilol) or other medications, given in small doses, may benefit some patients.
To reduce fluid accumulation you may need to take diuretics (water pills) such as loop diuretics (furosemide or bumetanide) for moderate to severe symptoms, or thiazide diuretics (hydrochlorothiazide, chlorthalidone and chlorothiazide) for mild symptoms, or a diuretic combination. Potassium-sparing diuretics (spironolactone, triamterene) are frequently used as well to prevent excessive potassium losses.
Digitalis may be prescribed to increase the muscle contraction of the heart and help the heart pumping function during atrial fibrillation (a common arrhythmia in right-sided heart failure).
Daily aspirin is appropriate when the underlying cause of heart failure is atherosclerotic heart disease.
If your symptoms are severe, unstable or don't improve with initial treatment, you may need hospitalization. Bed rest, reduced physical activity and intravenous medications help minimize the heart's workload.
Long-term recommendations may include:
Expectations (prognosis) Return to top
Heart failure is a serious disorder that carries a possibility of reduced life expectancy. There is no cure, but many forms of heart failure can be controlled with medication and correction of the underlying disorders. Heart failure may take the form of a chronic illness, and it worsens with an infection or other physical stressors.
Complications Return to top
Calling your health care provider Return to top
Call your health care provider if you notice symptoms of congestive heart failure or if you have right-sided heart failure and your symptoms change, worsen, or do not improve with treatment.
Also call if chest pain, weakness, fainting, rapid or irregular heartbeat, sudden weight gain, swelling, or other new or unexplained symptoms develop.
Prevention Return to top
Follow your health care provider's recommendations for treatment of conditions that may cause congestive heart failure. Follow dietary guidelines, in particular, reduce intake of salty foods and avoid adding salt to meals. Minimize or eliminate smoking and alcohol consumption.
Update Date: 2/27/2003 Updated by: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc.
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Page last updated: 28 October 2004 |