Right-sided heart failure is a condition in which the right side of the heart loses its ability to pump blood efficiently.

Right-sided heart failure occurs in about 1 in 20 people. Coronary artery disease is the most common cause of heart failure in the United States, but it can be a complication of other conditions.

Heart failure may affect the right side of the heart (right ventricle), the left side (left ventricle), or both sides. In right-sided heart failure, the right ventricle loses its pumping function, 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 right ventricle may be unable to pump blood efficiently to the lungs and to the left ventricle.

Causes of right-sided heart failure include left-sided heart failure and lung diseases such as chronic bronchitis and emphysema. Other causes include congenital heart disease, clots in pulmonary arteries, pulmonary hypertension, and heart valve disease.

• Shortness of breath
• Swelling of feet and ankles
• Urinating more frequently at night
• Pronounced neck veins
• Palpitations (sensation of feeling the heart beat)
• Irregular fast heartbeat
• Fatigue
• Weakness
• Fainting

A variety of different situations may trigger an episode of heart failure, including:

• Increased intake of fluids or salt
• Fever
• Infections
• Anemia
• Blockage in the coronary arteries
• Irregular heartbeats (arrhythmias)
• Overactive thyroid gland (hyperthyroidism)
• Kidney disease

Many people admitted to the hospital with heart failure do not follow a recommended low-salt diet or take heart failure medicines as prescribed.

Your health care provider will conduct a physical examination, which may reveal:

• Abnormal heart sounds
• Abnormal lung sounds
• Murmurs
• Irregular or rapid heartbeat
• Weight gain
• Distended neck veins
• Enlarged liver
• Ankle swelling

Heart failure patients may undergo some of the following common tests:

• An ECG, to look for signs of thickened heart muscle or enlarged heart chambers. The electric system of the heart and heart rhythm may not be normal.
• A chest x-ray, to look for enlargement of the heart and fluid accumulation in the lungs.
• An echocardiogram (heart ultrasound) and a Doppler study, which may show heart chambers enlargement, leaky valves, and poor pumping function.

The following lab tests may be performed:

• CBC
• Blood chemistry
• Liver function tests
• Urinalysis
• Thyroid function tests
• B-Type Natriuretic Peptide (BNP)

Cardiac catheterization may be performed. In right heart catheterization, a catheter is inserted through a vein into the right side of the heart to measures the pressures. Sometimes, an injection of contrast material ("dye") in the right ventricle is necessary to help understand the problem (right ventriculography).

The left ventricle and arteries in a similar fashion.