Signs of Right-Sided Heart Failure

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When your heart is healthy, it evenly moves your blood throughout your body. But, if your heart muscles begin to weaken, they can’t pump enough blood through your body.

Heart failure can affect just one side of your heart or both sides. This article covers the signs of right-sided heart failure and when you should seek medical attention for your symptoms.

nurse using stethoscope on hospital patient

 Jose Luis Pelaez Inc / Getty Images

Frequent Symptoms

When your heart is healthy, blood moves from your veins into the right side of your heart. From there, it goes into the lungs to pick up oxygen, then moves through the left side of your heart and is pumped through the rest of your body.

If you have right-sided heart failure, the right side of your heart can’t handle all the blood being returned to it by your veins. Consequently, blood begins to back up in your veins.

Here are some of the common signs of right-sided heart failure:

  • Swelling in legs and feet (known as edema): When your blood backs up in your veins, some of the fluid can escape from your veins into the surrounding tissues. Swelling and fluid retention is one of the most common symptoms of heart failure.
  • Shortness of breath: Feeling short of breath after doing everyday activities is one of the early signs of heart failure because you aren’t getting enough oxygen from your blood. As your heart grows weaker, you may notice trouble catching your breath after simpler activities like getting dressed.
  • Coughing: As your heart grows weaker, you may feel the need to cough more regularly.
  • Swelling in the abdomen: Fluid may accumulate in your abdominal cavity from heart failure. This is also known as ascites.
  • Dizziness and difficulty concentrating: A weaker heart could lower the amount of oxygen getting to your brain. This may lead to trouble focusing, confusion, and dizziness.
  • Chest discomfort: Swelling and fluid in your chest can leave you feeling pressure or pain in your chest.
  • Increased need to urinate: Needing to go more frequently, especially at night, could be a sign of heart failure.
  • Fatigue: Feeling low on energy often could be a sign of heart failure. You may feel like it is more difficult to sleep from trouble breathing while lying flat and increased need to use the bathroom at night.
  • Poor appetite and nausea: Fluid buildup in your abdomen puts pressure on your stomach. This may make you feel full quickly, suppress your appetite, and leave you feeling sick or nauseous.
  • Gaining weight quickly: A sudden increase in weight (5 pounds or more within a few days) could be a sign you are retaining fluid.

Rare Symptoms

Less common symptoms of right-sided heart failure can be indicators of worsening heart function, and some symptoms can be life threatening.

Rare symptoms include:

  • Bulging veins in your neck: Swelling in the veins in your neck can be a sign of heart failure.
  • Pulmonary edema: Fluid buildup in your lungs happens more often as heart failure progresses and is usually a sign that the left side of the heart is also affected. Pulmonary edema causes difficulty breathing, especially when laying flat, and can become life threatening without treatment.
  • Heart palpitations and irregular heartbeat: Feeling like your heart is racing, fluttering, or skipping a beat isn’t always a sign of heart problems, but these can be symptoms of right-sided heart failure.
  • Fainting or passing out: If you pass out or lose consciousness, it could be a sign of a medical emergency. It’s recommended to call your doctor or seek medical attention if you or a loved one experiences this.
  • Coughing up pink or bloody mucus: If you are coughing up blood-tinged mucus, this could be a sign of worsening pulmonary edema. Contact your doctor or seek medical attention if you notice pink, blood-tinged phlegm.
  • Low blood pressure: Low blood pressure, also called hypotension, occurs in about 10% to 15% of people with heart failure. It’s usually a later symptom of heart failure and often indicates a low ejection fraction (the percent of blood moving out of the heart with each pump).

Complications

If you have heart failure, it can take a toll on other areas of your body. Complications of right-sided heart failure can include:

  • Liver damage: If fluid builds up in your abdomen, it can put pressure on the blood vessels around your liver. Over time, this can lead to scarring and tissue damage in your liver which interferes with healthy liver function.
  • Kidney damage: The fluid and blood flow changes from heart failure can lead to chronic kidney disease or renal failure. If left untreated, renal failure can require long-term dialysis.
  • Malnutrition: Heart failure can lower your appetite and energy levels, making it difficult to eat the amount of food your body needs. Low food intake can lead to severe muscle and fat loss, as well as vitamin and mineral deficiencies.
  • Heart valve dysfunction: The valves in your heart keep blood flowing in the right direction. Weakened muscles and backed-up blood can interfere with these valves. Weak heart valves may lead to blood leaking back through the valve instead of moving forward.
  • Cardiac arrest: Heart failure increases the risk for sudden cardiac arrest (heart attack).

When to See a Doctor

It’s a good idea to speak with your doctor to check your heart health if you:

  • Notice swelling in your legs
  • Become winded easily with normal activities

There is no cure for heart failure. Still, with treatment, you can slow the progression of it and stay feeling better for longer.

You should seek immediate medical attention or call 911 if you or a loved one is experiencing:

  • Sudden shortness of breath, irregular heartbeat, or chest pain
  • Trouble breathing and blood-tinged phlegm
  • Fainting or loss of consciousness

A Word From Verywell

Experiencing problems with your heart can be frightening, leading some people to ignore the symptoms. You likely won’t experience all of the signs of right-sided heart failure right away. It’s important to share symptoms that seem minor and any changes in your health with your doctor.

While there is no treatment to reverse heart failure, medications and lifestyle changes can help keep your heart muscles strong and slow the progression of heart failure.

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  1. American Heart Association. Types of heart failure. Updated May 31, 2017.

  2. Cautela J, Tartiere J-M, Cohen-Solal A, et al. Management of low blood pressure in ambulatory heart failure with reduced ejection fraction patients. European Journal of Heart Failure. 2020;22(8):1357-1365. doi:10.1002/ejhf.1835

  3. National Heart, Lung, and Blood Institute. Heart failure.