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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Right Heart Failure: Causes, Symptoms, and Treatment
Introduction
Right heart failure (RHF) occurs when the right ventricle of the heart cannot pump blood efficiently into the lungs. This causes blood to back up in the veins, leading to fluid retention and swelling in the lower limbs, liver, and abdomen.
Causes of Right Heart Failure
RHF is often a consequence of left-sided heart failure, but it can also result from other conditions, including: - Pulmonary Hypertension: Increased pressure in the lung arteries makes it harder for the right ventricle to pump blood. - Chronic Lung Diseases (Cor Pulmonale): Conditions like COPD or pulmonary fibrosis increase lung resistance. - Congenital Heart Diseases: Malformations present from birth can overload the right ventricle. - Pulmonary Embolism: A blood clot in the lungs can suddenly increase the burden on the right heart. - Myocardial Infarction: A heart attack affecting the right ventricle can reduce its function.
Symptoms of Right Heart Failure
- Swelling in the legs, ankles, and abdomen (edema)
- Increased jugular venous pressure (visible neck vein swelling)
- Fatigue and weakness
- Shortness of breath, especially during exertion
- Abdominal discomfort due to liver congestion
Diagnosis
Doctors use a combination of tests to diagnose RHF: - Echocardiography: Assesses heart function and pressures. - Electrocardiogram (ECG): Identifies strain or damage to the heart muscle. - Chest X-ray: Shows lung congestion and heart size. - Cardiac MRI or CT Scan: Provides detailed heart images. - Right Heart Catheterization: Measures pulmonary artery pressures, confirming pulmonary hypertension.
Treatment Approaches
Treatment depends on the underlying cause:
1. Managing Fluid Retention
- Diuretics: Reduce swelling and fluid overload.
- Sodium Restriction: Limits fluid buildup.
2. Enhancing Right Ventricular Function
- Oxygen Therapy (if hypoxia is present)
- Pulmonary Vasodilators for patients with pulmonary hypertension
- Inotropic Support (e.g., dobutamine) in severe cases
3. Treating the Underlying Condition
- Pulmonary Embolism → Anticoagulation Therapy
- Chronic Lung Disease → Optimal COPD/Asthma management
- Heart Failure with Reduced Ejection Fraction → Beta-blockers, ACE inhibitors, or ARNi
4. Surgical and Device-Based Interventions
- Heart Transplantation (in end-stage cases)
- Implantable Cardioverter-Defibrillators (ICD) for arrhythmia prevention
- Pulmonary Endarterectomy (in selected cases of chronic thromboembolic pulmonary hypertension)
Prognosis and Lifestyle Modifications
- Regular exercise adapted to tolerance
- Healthy diet with controlled salt intake
- Avoidance of tobacco and alcohol
- Close monitoring of body weight and fluid status
Conclusion
Right heart failure is a serious condition, but with appropriate treatment and lifestyle changes, many patients can maintain a good quality of life. Early diagnosis and management of underlying conditions are key to preventing progression.
Source recommendations
1. American College of Cardiology/American Heart Association Heart Failure Guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://www.acc.org/Guidelines
- https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
- https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
- https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
2. European Society of Cardiology Heart Failure Guidelines
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
- https://academic.oup.com/eurheartj/article/44/37/3627/7246292
- https://pubmed.ncbi.nlm.nih.gov/21159794/
3. Pulmonary Hypertension Guidelines (ESC/ERS)
- https://academic.oup.com/eurheartj/article/43/38/3618/6673929
- https://publications.ersnet.org/content/erj/early/2022/08/25/1399300300879-2022.abstract
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pulmonary-Hypertension-Guidelines-on-Diagnosis-and-Treatment-of
- https://pubmed.ncbi.nlm.nih.gov/36017548/
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/08/30/19/11/2022-ESC-Guidelines-for-Pulmonary-Hypertension-ESC-2022
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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