Causes of right-sided heart failure

The most common cause of right-sided heart failure is actually left-sided heart failure (either systolic or diastolic heart failure). The table below outlines the causes of right-sided heart failure.

Causes of right-sided heart failure

Cause

What is it?

How does it cause right-sided heart failure?

Left-sided heart failure The left ventricle does not pump blood efficiently, leading to pressure buildup behind the left side of the heart that eventually causes the right side of the heart to fail. Blood backs up behind the left ventricle into the left atrium, in the lungs, and then eventually in to the right ventricle, which also eventually fails, allowing blood to then back up farther into the extremities, the liver, and the other organs.
Chronic lung disease Includes emphysema, pulmonary embolism, and other causes of pulmonary hypertension High blood pressure in the pulmonary arteries increases the workload of the right ventricle, eventually causing the right ventricle to fail.
Coronary artery disease Blockage of the arteries that supply blood to your heart CAD can cause left-sided heart failure leading to right-sided heart failure or can directly cause right-sided heart failure by blocking blood supply to the right ventricle.
Pulmonic stenosis Narrowing of the pulmonic valve that limits blood flow out of the right ventricle Increases the work of the right ventricle; similar to chronic lung disease
Tricuspid stenosis Narrowing of the tricuspid valve Limits blood flow out of the right atrium, causing enlargement of the right atrium and backup of blood flowing to it
Tricuspid regurgitation Tricuspid valve doesn't close properly, causing blood in the right ventricle to flow back into the right atrium Causes volume overload of the right ventricle, which eventually causes right ventricular dilatation and failure
Pericardial constriction The pericardium is a membrane sac around the heart. Repeated or ongoing inflammation of it causes stiffening and thickening and prevents the heart from expanding normally to pump. A thickened pericardium restricts the heart's ability to pump effectively.
Left-to-right shunt An abnormal connection between the left and right side of the heart, usually present from birth Causes a volume overload of the right ventricle, similar to tricuspid regurgitation

Last Updated: August 25, 2008

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