Left- or Right-Sided Heart Failure

The heart is a large muscle that acts as a pump to circulate blood throughout the body. Blood carries oxygen to all of the organs including the brain, muscles, and skin. After your body takes the oxygen out of the blood, the blood returns to the heart. The right side of the heart collects the blood from the body and pumps it to the lungs. In the lungs, it gets fresh oxygen and gives up carbon dioxide. The oxygen-rich blood from the lungs then returns to the left side of the heart, where it is pumped back out to the rest of your body, starting the process all over.

Heart failure (HF) occurs when the heart muscle does not function normally. This causes your body to retain fluids or reduce blood flow. This can be caused by several health problems that weaken or stiffen the heart muscle. Heart failure can affect the right or the left side of the heart. It can often involve both sides of the heart over time.

Right-sided heart failure

When the right side of the heart is failing, it can’t handle the blood it is getting from the rest of the body. This blood returns to the heart through veins. When too much pressure builds up in the veins, fluid leaks out into the tissues. Gravity then causes that fluid to move to those parts of the body that are the lowest. So one of the first symptoms of right-side HF can include swelling in the feet and ankles. If the condition gets worse, the swelling can even go up past the knees. Sometimes it gets so severe, the liver and intestines can get congested as well.

Left-sided heart failure

When the left side of the heart is failing, it can’t handle the blood it gets from the lungs. Pressure then builds up in the veins of the lungs. This causes fluid to leak into the lung tissues. This causes you to feel short of breath, weak, or dizzy. These symptoms are often worse with physical activity, such as when climbing stairs or walking up hills. Lying with your head flat is uncomfortable and can make your breathing worse. This may make sleeping difficult. You may need to use extra pillows to elevate your upper body to sleep well. The same is true when just resting during the daytime. You may also feel weak or tired and have less energy during exertion.

Heart failure can have many causes of heart failure. They include:

  • Coronary artery disease

  • High blood pressure

  • Previous heart attack

  • Diabetes

  • Obesity

  • Alcohol abuse

  • Smoking

  • Illegal drug use, such as methamphetamine

  • Family history

  • Inflammatory conditions including infection

  • Unknown cause (idiopathic)

Heart failure is usually a long-term (chronic) condition. The purpose of medical treatment is to improve how well the heart pumps and to remove extra water from the body. A number of medicines can help with this, improve symptoms, and prevent the heart from becoming weaker. In certain cases, cardiac procedures or surgery can help to treat heart failure. Sometimes heart failure can become so severe that a device is placed in the heart to help it pump. Or a heart transplant is advised. Another major goal is to better treat the causes of heart failure, such as diabetes and high blood pressure. You may need to make changes in your lifestyle..

Home care

Follow these guidelines when caring for yourself at home:

  • Check your weight every day. This is very important because a sudden increase in weight gain could mean the heart failure is getting worse. Keep these things in mind:

    • Use the same scale every day.

    • Weigh yourself at the same time every day. Wear similar clothing or no clothes at all.

    • Make sure the scale is on a hard floor surface, not on a rug or carpet.

    • Keep a record of your weight every day so your healthcare provider can see it. If you are not given a log sheet for this, keep a separate journal for this purpose. 

  • Cut back on the amount of salt (sodium) you eat. Follow your healthcare provider's advice on how much salt or sodium you should have each day.

    • Limit high-salt foods. These include olives, pickles, smoked meats, salted potato chips, and most prepared foods.

    • Don't add salt to your food at the table. Use only small amounts of salt when cooking.

    • Read the labels carefully on food packages to learn how much salt or sodium is in each serving in the package. Remember that a can or package of food may contain more than 1 serving. So if you eat all the food in the package, you may be getting more salt than you think.

  • Follow your healthcare provider's advice about how much fluid you should have. Be aware that some foods such as soup, pudding, and juicy fruits like oranges or melons contain liquid. You'll need to count the liquid in those foods as part of your daily fluid intake. Your provider can help you with this.

  • Stop smoking.

  • Stop using illegal drugs.

  • Cut back on how much alcohol you drink.

  • Lose weight if you are overweight. The extra weight puts a lot of stress on the heart.

  • Stay active. Talk with your provider about an exercise program that is safe for your heart.

  • Keep your feet elevated to reduce swelling. Ask your provider about support hose to prevent daytime leg swelling.

Besides taking your medicine as instructed, an important part of treatment is lifestyle changes. These include diet, physical activity, stopping smoking, and weight control.

Improve your diet by including more fresh foods, cutting back on how much sugar and saturated fat you eat, and eating fewer processed foods and less salt.

Follow-up care

Follow up with your healthcare provider, or as advised.

Make sure to keep any appointments that were made for you. These can help better control your heart failure. You will need to follow up with your provider on a routine basis to make sure your heart failure is well managed.

If an X-ray, electrocardiogram (ECG), or other tests were done, you will be told of any new findings that may affect your care.

Call 911

Call 911 if you:

  • Become severely short of breath

  • Feel lightheaded, or feel like you might pass out or faint

  • Have chest pain or discomfort that is different than usual, the medicines your doctor told you to use for this don't help, or the pain lasts longer than 10 to 15 minutes

  • You suddenly develop a rapid heart rate

When to seek medical advice

The following may be signs that your heart failure is getting worse. Call your healthcare provider right away if any of these happen:

  • Sudden weight gain. This means 3 or more pounds in one day, or  5 or more pounds in 1 week.

  • Trouble breathing not related to being active

  • New or increased swelling of your legs or ankles

  • Swelling or pain in your abdomen

  • Breathing trouble at night. This means waking up short of breath or needing more pillows to breathe.

  • Frequent coughing that doesn’t go away

  • Feeling much more tired than usual

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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