difference between right sided and left sided heart failure

akulahawkRN, ADN, RN, EMT-P · Nov 12, 2011

Fluid in in the lungs that's related to heart failure has to do with pressure. Figure out why the pressure is there and you'll have your answer. Think of it like this... you have 2 separate pumps that interconnect 2 circulation systems and fluid can't get to the other circuit without going through a pump... what happens when one pump fails?

Sorry if I'm being a little cryptic, but I'm trying to lead you toward an understanding of the problem rather than spoon-feeding. You'll retain it far better.

AngelofSeduction · Nov 12, 2011

ok thanks for replying but that didnt really answer my question and im not asking to be spoon fed.im just trying to understand it better.and obviously if one side is not working the other has to compensate but it can only do it for so long then that one stop working also.im just trying to put the connection of how right sided lead to peripheral edema and so on

metricalpound · Nov 12, 2011

Ok the heart is a two-sided pump - think of it as where the blood is going.

If you have right-sided heart failure then the blood is going to back up in your right atrium, to yr superior vena cava and where else? Where is that blood going? What will the manifestations be?

If you have left-sided heart failure, then the blood is going to back up in your left atrium, to your pulmonary trunk, and where else? Where is that blood going? What will the manifestations be?

akulahawkRN, ADN, RN, EMT-P · Nov 12, 2011

ok thanks for replying but that didnt really answer my question and im not asking to be spoon fed.im just trying to understand it better.and obviously if one side is not working the other has to compensate but it can only do it for so long then that one stop working also.im just trying to put the connection of how right sided lead to peripheral edema and so on

The answer, believe it or not, is teased in my earlier response.

Please excuse the anatomic simplicity for the concepts that are presented.

The left side receives blood from the pulmonary circuit and pushes blood out to the body. The right side receives blood from the body and pushes it through the pulmonary circuit. Both sides have to have equal volume out to prevent an overload on either side.

So, a right sided failure results in essentially congestion in the veins of the systemic (from the left heart) side, resulting in a fluid overload of that side of the system, so the fluid has to go somewhere! A left sided failure results in a fluid overload of the pulmonary circuit, and again, the fluid has to go somewhere.

Early on, the "good" side is going to compensate some for the "bad" side, so you might not see much in the way of frank signs and symptoms at first...

Do some thinking and you might "see" where and what the S/Sx will be for failure of each side.

Cuddleswithpuddles · Nov 12, 2011

You need to have a solid understanding of the pathway the blood takes through the heart. After that, it is just a matter of thinking of heart failure as a freeway accident. You're trying to get from point A to point C, but there is an accident at point B. Imagine the backup that will happen on the freeway before you get to point B.

Same thing with heart failure.

OK, so now let's tackle right-sided heart failure. There is a fender bender in the right side of the heart and there is going to be a backup in all points before that.

Before the blood gets into the right side of heart, where was it? What blood vessels? What body parts?

Recall that the right side of the heart receives blood from the venous circulation---blood that is coming back from the head, the arms, the legs etc. etc. This is where you will see the backup in right sided heart failure as manifested by things such as edema and neck vein engorgement.

With left sided heart failure, there is a backup of blood entering the left side of the heart. Where did it come from? The lungs! The blood is an important businessman on his way to do his job but there is an accident on Left Atrium Ave. and Left Ventricle Blvd. and he's stuck in the lungs.

Does that help any?

I like goofy analogies, yes.

Always_Learning, BSN, RN · Nov 12, 2011

I came up with a simple saying to remember how right and left sided heart failure manifests: "Left is lungs, right is remote." (Meaning left sided heart failure has pulmonary symptoms, and right sided heart failure results in peripheral edema...except peripheral didn't start with an "R", so I changed it a little...LOL).

I have a video that I think demonstrates the bloodflow through the heart really well. As you watch it, think about where the blood is coming from. If that side of the heart isn't working well, the blood backs up...where will it go?

AgentBeast, MSN, RN · Nov 12, 2011

Fluid backs up behind the side of the heart that is failing.

Right sided heart failure fluid backs up into the body.

Left sided heart failure fluid backs up into the lungs.

AngelofSeduction · Nov 12, 2011

thanks for all your responses. i understand it better now.the way i learned anatomy was more than just thinking of the heart as "simple" so it just takes a little time to really think about it and put two and two together

akulahawkRN, ADN, RN, EMT-P · Nov 12, 2011

What the heart does (it's job) is pretty simple. It's how it gets that job done (and all the coordination with it) that gets complex.

suanna · Nov 13, 2011

ok thanks for replying but that didnt really answer my question and im not asking to be spoon fed.im just trying to understand it better.and obviously if one side is not working the other has to compensate but it can only do it for so long then that one stop working also.im just trying to put the connection of how right sided lead to peripheral edema and so on

I don't think you are understanding the picture at all. If the Left heard is in failure there is nothing the R heart is going to do to "compensate". Start by undrstanding what the function of L heart and R heart are and the answer is automatic.