| Symptoms of left heart failure | Symptoms of right-sided heart failure |
| Difficulty breathing or gasping for breath | Nausea |
| Cough | Loss of appetite |
| Fatigue, extreme fatigue despite good rest | Stomach pain |
| Weakness | Swelling of lower legs, stomach and neck veins |
| Bluish lips and fingers | Increased urination |
| Problems with concentration | Unexplained weight gain |
| Difficulty sleeping while lying flat |
The main difference is that left and right heart failure occur on their side of the heart. Each type has different underlying causes, and one is more common than the other.
Their causes
The most common causes of left-sided heart failure are coronary artery disease (restricted blood flow to the heart due to plaque build-up in the coronary arteries) and hypertension (high blood pressure).
Other risk factors for left-sided heart failure include:
- diabetes
- Smoking
- obesity
- Cardiomyopathy (heart muscle disease)
- Inactive lifestyle
Right-sided heart failure is often caused by left-sided heart failure. As the left ventricle (lower chamber) weakens, the pressure in the heart increases and causes fluid to back up into the lungs. This fluid eventually moves to the right side of the heart.
Other conditions that can lead to right-sided heart failure include:
- Pneumonia
- Pulmonary embolism (a blood clot that travels to the lungs)
- Acute respiratory distress syndrome
- Pulmonary hypertension (high pressure in the lungs)
- Chronic obstructive pulmonary disease (COPD) or other lung diseases
Number of subtypes
Left-sided heart failure has two main types: systolic failure and diastolic failure.
In systolic heart failure, the left lower chamber of the heart does not contract well, which reduces its power to pump blood. Diastolic heart failure occurs when the left ventricle becomes too stiff to fill properly with blood during rest.
Right-sided heart failure is not broken down into any specific type.
Prevalence
Left-sided heart failure is more common than right-sided heart failure. Estimates suggest that more than half of people with heart failure have left-sided heart failure.
Both left and right heart failure can cause problems for other organs.
Fluid retention causes symptoms
When the heart doesn’t pump enough blood, fluid builds up in the body, causing symptoms like swelling, weight gain and shortness of breath. Drinking plenty of fluids and consuming too much sodium can contribute to fluid retention.
Some people with any type of heart failure may need to take medications such as diuretics to remove excess fluid. They may also need to be weighed regularly and have their pulse and blood pressure checked.
Organ strain
Left- and right-sided heart failure can strain the heart and other organs, potentially even leading to liver or kidney damage.
Reduced blood flow to the kidneys can disrupt their function and result in fluid build-up and increased waste levels in the body. Heart failure can also cause congestion in the liver, which can lead to scarring and reduced function over time.
Other possible complications from any type of heart failure include arrhythmias (irregular heartbeats), heart valve disease, and, in severe cases, sudden cardiac arrest.
Treatment options
Medicines, lifestyle changes, and implantable heart devices are common treatments to reduce symptoms and improve function for any type of heart failure.
Lifestyle changes can include maintaining an optimal weight, avoiding or quitting smoking, managing stress, getting enough rest, adjusting fluid and salt intake, and avoiding alcohol.
Medicines vary depending on the type and grade of heart failure you have, but may include medicines to control blood pressure and fluid retention.
Devices and procedures are usually reserved for people with heart failure that doesn’t respond to lifestyle changes and medications. In such cases, devices such as implantable cardioverter defibrillators (ICDs) can help monitor the heart’s rhythm and treat dangerous heartbeats.
It is possible that you have both left and right heart failure. When both sides of the heart are affected, it is called biventricular heart failure. This condition causes symptoms similar to any type of heart failure, including shortness of breath and fluid retention.
With both sides of the heart affected, biventricular heart failure can lead to more severe limitations in daily activities and may require a combination of treatments.
If you notice any symptoms of heart failure, see your primary care physician so they can diagnose or rule out heart failure. If you have already been diagnosed with heart failure, tell your cardiologist (heart specialist) or other healthcare professional about any sudden worsening of your symptoms.
Symptoms to look out for include:
- Rapid weight gain
- Shortness of breath, especially at rest
- Increased swelling of the legs or ankles
- Stomach pain or swelling
- Difficulty sleeping
- Persistent dry cough
- Difficulty in concentration
- Nausea and loss of appetite
- Heart palpitations
- Mood changes, such as sadness or depression
Left and right heart failure are two conditions that affect the way the heart pumps blood.
Left-sided heart failure causes blood to back up into the lungs, often leading to symptoms such as shortness of breath and coughing. Right-sided heart failure causes blood to back up into the veins, leading to swelling in the legs, ankles, and abdomen.
Left-sided heart failure is more common and can lead to right-sided heart failure. Treatment options for both conditions include lifestyle changes, medications, and implantable devices to help manage symptoms and improve heart function.