Right-sided heart failure can be caused by many factors, the main culprits being left-sided heart failure, coronary artery disease and chronic lung disease. In this disorder, the right ventricle of the heart does not pump efficiently, causing fluid to accumulate in the body. This excess fluid causes congestion in the body organs, hence the name "congestive heart failure." According to an article posted in "The New York Times" Health Guide, right-sided heart failure strikes 1 person out of 20.
Swollen Abdomen
In right-sided heart failure, the abdomen swells due to liver enlargement and fluid retention in the abdominal area. The patient's girth may be measured on a regular basis to help determine the extent of fluid collection.
Voiding at Night
Another sign of right-sided congestive heart failure is voiding several times at night. This symptom can significantly disturb the patient's sleep and affect quality of life.
Swelled Fingers and Hands
According to "Medical-Surgical Nursing," swelling of the fingers and hands is one of the key features of right-sided heart failure. Again, this swelling is due to fluid accumulation.
Jugular Vein Distention
The jugular veins in the neck may become prominent. These veins drain blood from the brain toward the heart. Due to excess fluid accumulation, their pressure can become elevated.
Poor Appetite and Nausea
The patient with right-sided heart failure may have a poor appetite due to fluid pushing against the stomach from the abdominal cavity or liver. Fluid may also be present in the stomach, leading to nausea. According to the "Merck Manual," the stomach fluid can cause eaten food to not be properly absorbed and the muscles can begin to waste. Sometimes, this leads to weight loss, but often it does not because of the weight of the retained fluid.
Increased Heart Rate
The Times Health Guide article states that right-sided heart failure can cause a fast, irregular heartbeat. The patient may also suffer palpitations, which is a sensation of the heart pounding in the chest.
Weakness, Fatigue and Fainting
Right-sided heart failure leads to tiredness and a lack of endurance. Fatigue can be one of the more difficult symptoms to manage because daily activities must be carefully planned to conserve energy. Fainting occurs rarely with this type of heart failure.
Swelled Legs and Feet
Dependent edema is a cardinal sign of right-sided congestive heart failure. This means that fluid accumulates in the lower parts of the body. When sitting or standing, the feet, ankles and legs begin to swell. If a patient is bedridden, the area at the base of his spine may be swollen.
Changes in Blood Pressure
According to "Medical-Surgical Nursing," one of two things can happen to the blood pressure. It often becomes increased due to excess fluid in the blood. For other patients, the blood pressure drops due to the failure of the heart to pump efficiently.
Weight Gain
Weight gain occurs with right-sided heart failure due to fluid collection. Often, the weight is checked daily to ensure that a dangerous amount of fluid is not developing.
Enlarged Liver and Spleen
The liver and spleen may become enlarged due to fluid collection. The patient rarely realizes his spleen is enlarged, but the swollen liver may be palpable and press upon other organs.
Shortness of Breath
According to the Times Health Guide article, right-sided heart failure can cause shortness of breath. This is not as pronounced as the breathing difficulties found in left-sided heart failure.
References
- Merck Manual: Home Edition: Heart Failure
- "Medical-Surgical Nursing;" Donna D. Ignatavicius, M.S. and M. Linda Workman, Ph.D.; 2002
- The New York Times: Health Guide: Right-Sided Heart Failure
