Comparing Left vs. Right Sided Heart Failure

The main difference is that left- and right-sided heart failure occur in their respective sides 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 your heart due to plaque buildup in your coronary arteries) and hypertension (high blood pressure).

Other risk factors of left-sided heart failure include:

• Diabetes
• Smoking
• Obesity
• Cardiomyopathy (disease of the heart muscle)
• An inactive lifestyle

Right-sided heart failure is often caused by left-sided heart failure. As the left ventricle (lower chamber) weakens, pressure in the heart rises and causes fluid to back up into the lungs. This fluid eventually moves into 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 heart’s left lower chamber doesn’t contract well, which reduces its force for pumping blood. Diastolic heart failure happens when the left ventricle becomes too stiff to fill with blood properly during rest.

Right-sided heart failure isn’t broken down into any specific types.

Prevalence

Left-sided heart failure is more common than right-sided heart failure. Estimates suggest that over half of people with heart failure have left-sided heart failure.

Both left- and right-sided 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 lots of liquids and consuming too much sodium can add to fluid retention.

Some people with either type of heart failure may need to take medications such as diuretics to remove the excess fluid. They may also need to weigh themselves regularly and check their pulse and blood pressure.

Strain on Organs

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 may impair their function and result in fluid buildup and elevated 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 either type of heart failure include arrhythmias (irregular heartbeats), heart valve disease, and, in severe cases, sudden cardiac arrest.

Treatment Options

Medications, lifestyle changes, and implantable cardiac devices are common treatments to reduce symptoms and improve function for either type of heart failure.

Lifestyle changes may include maintaining an optimal weight, avoiding or quitting smoking, managing stress, getting enough rest, adjusting fluid and salt intake, and avoiding alcohol.

Medications vary by the type and class of heart failure you have but may include drugs to manage blood pressure and fluid retention.

Devices and procedures are usually reserved for people with heart failure who don’t respond to lifestyle changes and medications. In such cases, devices like implantable cardioverter defibrillators (ICDs) may help monitor heart rhythm and treat dangerous heartbeats.

It’s possible to have both left- and right-sided heart failure. When both sides of the heart are affected, it is called biventricular heart failure. This condition causes symptoms similar to each type of heart failure, including shortness of breath and fluid buildup.

With both sides of the heart compromised, 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, contact your primary healthcare provider so they can diagnose or rule out heart failure. If you already have a heart failure diagnosis, let your cardiologist (heart specialist) or other healthcare provider know about any sudden worsening of symptoms.

Symptoms to watch for include:

• Quick weight gain
• Shortness of breath, especially at rest
• Increased swelling in legs or ankles
• Stomach pain or swelling
• Difficulty sleeping
• Persistent dry cough
• Difficulty concentrating
• Nausea and loss of appetite loss
• Heart palpitations
• Mood changes, such as sadness or depression

Left-sided and right-sided heart failure are two conditions that affect the way the heart pumps blood.

Left-sided heart failure causes blood to back up in the lungs, often leading to symptoms like shortness of breath and coughing. Right-sided heart failure causes blood to back up in the veins, leading to swelling in the legs, ankles, and abdomen.

Left-sided heart failure is more common and may lead to right-sided failure. Treatment options for either condition include lifestyle changes, medications, and implantable devices to help manage symptoms and improve heart function.