Definition
Right-sided heart failure (RHF) is the inability of the right ventricle to pump blood effectively into the pulmonary circulation, resulting in systemic venous congestion and fluid retention in the body.
Etiology & Pathophysiology
- Secondary to Left-Sided Heart Failure The most common cause. When the left ventricle fails, pressure builds up in the pulmonary circulation. This increased afterload burdens the right ventricle, leading to hypertrophy, and eventually right-sided failure.
- Cor Pulmonale (Pulmonary Heart Disease) Chronic lung conditions (e.g. COPD, pulmonary fibrosis) cause pulmonary hypertension, increasing resistance in pulmonary arteries. The right ventricle must work harder to overcome this pressure → leads to right ventricular hypertrophy and later decompensation.
- Left-to-Right Cardiac Shunts (e.g. ASD, VSD) These defects allow blood to pass from the left heart into the right heart, increasing volume load. Chronic overload leads to dilation and hypertrophy of the right ventricle → failure over time.
- Valvular Heart Diseases Tricuspid or pulmonary valve stenosis or regurgitation can cause pressure or volume overload in the right heart → failure.