Covers right-sided heart failure, defined as the right ventricle's inability to pump blood into the pulmonary circulation, leading to systemic venous congestion. It goes through causes including left-sided failure, cor pulmonale, left-to-right shunts and valve disease, then symptoms such as oedema, raised jugular venous pressure, hepatosplenomegaly and ascites. Physical signs, laboratory findings, and chest X-ray, ECG and echocardiography features are also described, with numeric echo and ECG criteria included.
Topic 12 of 88 in the MU Sofia syllabus for Internal Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 7 sections, about 563 words (4 min of reading), with 15 flashcards.
In this note
Acute and Chronic Right-Sided Heart Failure
Definition
Etiology & Pathophysiology
Symptoms
Physical Examination
Laboratory Tests (same as LHF)
Instrumental Tests
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.
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