Left-Sided Heart Failure vs. Right-Sided Heart Failure

Heart failure is a condition where the heart is weakened and unable to pump blood effectively, resulting in insufficient blood flow to the body’s organs and systems. Heart failure can be acute, meaning that it appears suddenly but goes away relatively quickly. This may be the case following a heart attack or if there are problems with the heart valves.

The majority of cases of heart failure, however, are chronic. This means that symptoms persist and don’t improve over time. The Centers for Disease Control and Prevention (CDC) estimates that 5.7 million Americans have heart failure. The condition is more common in men, but women are more likely to die from heart failure if it is not treated. We will outline the different types of heart failure, their diagnosis, left vs right heart failure symptoms, and the treatment options.

What Is the Difference Between Left and Right-Sided Heart Failure?

Heart failure can occur in the left side of the heart, the right side of the heart, or on both sides. The major difference between left-sided heart failure and right-sided heart failure is in the side of the heart that is weakened. In left-sided heart failure, the left side of the heart is weakened and results in reduced ability for the heart to pump blood into the body. In right-sided heart failure, the right side of the heart is weakened and results in fluid in your veins, causing swelling in the legs, ankles, and liver.

To understand these conditions, it is important to know a little about how blood flows through the heart.

How Does the Left Ventricle Differ from the Right Ventricle?

The heart is made up of four chambers. The upper chambers are called atria and the lower chambers are called ventricles. Each side of the heart has paired upper and lower chambers. Blood returns from the body and enters the right atrium. From there it moves to the right ventricle, which pumps it to the lungs where it is oxygenated. Blood moves from the lungs into the left atrium, down to the left ventricle and then out to the body to supply organs and tissues with oxygen and nutrients.

What Is Left-Sided Heart Failure?

Left-sided heart failure (sometimes referred to as left ventricular or LV heart failure) is the more common of the two types. In this condition, the left ventricle is unable to pump blood out to the body efficiently. This is either because the ventricle can’t exert sufficient force to move the blood or because the ventricle can’t relax properly between beats and allow itself to fill with blood. As a result, blood backs up into the lungs.

What Is Right-Sided Heart Failure?

Right-sided heart failure (right ventricular or RV heart failure) can be caused by issues like lung disease, but most often it is the result of left-sided heart failure. The accumulation of blood in the lungs forces the right ventricle to be overworked and ultimately fails.

Signs and Symptoms of Left vs Right-Sided Heart Failure

Heart failure symptoms vary based on which side of the heart is affected. Left-sided heart failure primarily impacts the lungs, while right-sided heart failure leads to symptoms in the rest of the body. Recognizing the differences in symptoms can aid in early diagnosis and appropriate treatment.

Left-Sided vs Right-Sided Heart Failure Causes

The underlying causes of left-sided and right-sided heart failure differ, although they may overlap in some cases. Understanding these causes can help tailor prevention and treatment efforts.

Does Left-Sided Heart Failure Lead To Right-Sided Heart Failure?

Left-sided heart failure occurs when the left ventricle of the heart is weakened and cannot as efficiently pump blood into the body. As a result of the diminished ejection fraction, fluid can flow back into the lungs and put additional stress on the right side of the heart. This can lead to right-sided heart failure.

Risk Factors for Left or Right-Sided Heart Failure

Any of the below risk factors alone may be enough to cause left or right-sided heart failure, but a combination of these risk factors can significantly increase risk. Risk factors for heart failure include:

• Coronary artery disease
• Heart attack
• Heart valve disease
• High blood pressure
• Irregular heartbeat
• Congenital heart disease
• Diabetes
• Some diabetes medications
• Alcohol use
• Sleep apnea
• Smoking or tobacco use
• Obesity
• Viral infections

Left-Sided and Right-Sided Heart Failure Symptoms and Diagnosis

In addition to the symptoms noted above, left-sided and right-sided heart failure can cause:

• Rapid weight gain
• A persistent cough
• Fatigue
• Heart palpitations
• Protruding neck veins
• Irregular pulse

Doctors typically use a physical exam and a procedure called an echocardiogram to diagnose heart failure. The echocardiogram produces detailed images of the heart that the doctor reviews to assess the damage to the heart.

Left-Sided and Right-Sided Heart Failure Treatments

When heart failure is caught in the early stages, it is generally treated with medication. Different drugs are used to help the heart beat more effectively, lower cholesterol, prevent blood clots, slow the heart rate, help the body remove sodium and increase its potassium level as needed. People with heart failure must only take medication approved by their doctor. This includes over-the-counter medications.

In some cases, heart failure reaches a point where surgery is necessary. This can include coronary bypass surgery in which a section of a healthy artery is used to bypass a blocked blood vessel. A procedure called angioplasty may be used in other instances. It involves inserting a small balloon into a narrowed artery and inflating the balloon to widen it. The doctor may then insert a tube called a stent to ensure the artery remains expanded.

When all other treatments have failed, a heart transplant may be performed. This involves removing part or all of the heart and replacing it with a donor heart.

Left-Sided vs Right-Sided Heart Failure FAQs

What Happens When Both Sides of the Heart Fail?

When both sides of the heart fail, it’s called congestive heart failure. This severe condition leads to symptoms throughout the body, including extreme fatigue, shortness of breath, and widespread fluid retention. Treatment often involves medications, lifestyle changes, and medical interventions to improve quality of life.

What are the 4 Stages of Heart Failure?

Heart failure is classified into four stages, each reflecting the progression of the condition:

• Stage A – High risk of heart failure but no symptoms yet, typically due to underlying conditions like high blood pressure.
• Stage B – Structural heart disease is present, but there are no noticeable symptoms.
• Stage C – Structural heart disease with current or prior symptoms like shortness of breath and fatigue.
• Stage D – Advanced heart failure with severe symptoms even at rest, requiring specialized treatments and possible heart transplant consideration.

For more information on managing heart failure, visit Heart failure.

Explore the Difference between Right-Sided Heart Failure vs. Left with Baptist Health

Learn more about the signs of right sided heart failure vs left, and different types of heart failure, including symptoms and treatment options, by visiting Baptist Health Heart Care and finding a provider.