Right-sided heart failure can be defined as the right ventricle weakening to the point that blood flow is impaired and the body suffers. Impaired circulation can affect many body systems including the gut, liver, skin and lungs. When the right ventricle pump declines, fluid "backs up" resulting in swelling or edema.
Abdominal Signs and Symptoms
Blood enters the right heart from the venae cavae and the liver. The inferior and superior vena cava are returning blood from the lower and upper parts of the body, respectively. The liver, through the portal system, drains "filtered" blood into the heart. Blood from each of these sources is destined for the lungs to be oxygenated. When the pump of the right ventricle fails, blood backs up into the liver and the body. This buildup of fluid leads to swelling of the liver and abdomen, a condition known as ascites. This can cause abdominal pain, nausea, vomiting and loss of appetite. Bloating and constipation can result as well. As the heart failure worsens, blood flow to the intestines may be impaired leading to death of these tissues and symptoms such as pain and bloody stools.
Peripheral Signs and Symptoms
Failure of the right side of the heart leads to fluid accumulation; most notably, in the legs. This swelling or edema is affected by gravity so is more noticeable in the feet and ankles. If severe enough, the skin will indent when pushed, a condition known as pitting edema. This edema will ascend up the leg as the condition worsens. Swelling of the face and upper extremities is uncommon, but possible.
Heart and Lung Signs and Symptoms
Weakening of the cardiac pump leads to less blood leaving the heart. Thus, the right ventricle will enlarge. This condition, as well as a decrease in the strength of contraction of the heart, can be seen by an echocardiogram, which is an ultrasound examination of the heart. An increase in pressure in the jugular veins can be detected by visual and tactile inspection.
Although more common in left heart failure, shortness of breath and fluid buildup in the lungs can occur with severe right heart failure.
General Signs and Symptoms
Right heart failure leads to an inefficiency in blood circulation. This, in turn, causes generalized fatigue and tiredness. Stamina is reduced and weakness of the muscles is experienced.
