Left sided heart failure occurs when there is weakness or damage in the left side of the heart. Right sided heart failure develops when there is weakness of the muscles in the right side of the heart. A person may develop one or both types.

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Heart failure occurs when the heart muscles cannot pump blood effectively through the body and the tissues do not receive enough oxygen.

This article provides information on left sided and right sided heart failure, the symptoms and causes of each, and how one may affect the other.

It also looks at the risk factors and treatment options and answers some frequently asked questions.

The following table outlines the key differences between left sided and right sided heart failure.

Left heart failureRight heart failure
DefinitionThe left ventricle cannot pump blood as it should. This causes blood to build up in the veins of the lungs.The right ventricle cannot pump blood effectively, which leads to a buildup of fluid that causes swelling in the lower body.
Common causesheart attack
• chronic high blood pressure
coronary artery disease (CAD)
• left sided heart failure
chronic obstructive pulmonary disease (COPD)
• other lung diseases
FrequencyLeft heart failure is the more common of the two.Isolated right heart failure is less common.
SymptomsSymptoms typically include congestion in the lungs, which can affect breathing.Symptoms typically include swelling and fluid retention in the body.
Neck vein pressureA person may have a mild to moderate increase in blood pressure in the jugular vein.Blood pressure in the jugular vein may increase significantly, which can cause the veins to distend.

The left ventricle is larger than other chambers of the heart, as it supplies most of the power the heart needs to pump blood. Left heart failure occurs when the left ventricle is unable to pump blood effectively around the body.

There are two types of left heart failure:

  • Systolic failure, or heart failure with reduced ejection fraction: In systolic heart failure, the left ventricle cannot contract in the usual manner and the heart cannot pump blood with enough force to propel blood into circulation.
  • Diastolic failure, or heart failure with preserved ejection fraction: In diastolic heart failure, the muscles of the left ventricle have stiffened and cannot relax normally and the heart cannot fill with blood between beats.

Symptoms may include:

  • shortness of breath
  • breathlessness while lying down
  • weight gain
  • swelling
  • low blood pressure
  • cough
  • fatigue
  • exercise intolerance

CAD and high blood pressure are common causes.

As the heart pumps, blood returns to the right ventricle through the right atrium. The right ventricle moves the blood back out of the heart to the lungs, where the blood gathers oxygen again.

When the right side of the heart cannot pump blood effectively, blood builds up in the veins. This can lead to swelling, fluid retention, and other symptoms.

Symptoms include:

Conditions that can cause right heart failure include:

Left heart failure is usually the cause of right heart failure.

When the left ventricle does not work properly, it causes increased fluid pressure through the lungs, which transfers to the right side of the heart.

When the right side of the heart cannot pump blood effectively, blood builds up in the veins. This can cause swelling in the legs, ankles, and abdomen.

Risk factors that may increase a person’s chance of developing heart failure include:

  • family history of the condition
  • age — the risk increases as a person gets older
  • high blood pressure
  • certain cancer treatments
  • diabetes
  • obesity
  • smoking, excessive alcohol consumption, and other lifestyle factors

There is no cure for heart failure, but lifestyle changes and treatment with medication and surgery can help improve symptoms and outcomes.

Doctors will also treat any underlying conditions.

According to the National Heart, Lung, and Blood Institute, treatment for heart failure includes the following:


Medications to treat left heart failure include medications to:

Medications to treat right heart failure include drugs to:

  • relax blood vessels, such as ARBs and ACE inhibitors
  • remove excess fluid and salt from the body, such as diuretics and aldosterone antagonists

Procedures and surgeries

In severe cases, a person may need surgery to implant a medical device, repair a defect, or conduct a heart transplant.

A person may need the following devices:

Sometimes surgery to correct congenital heart defects, valve problems, or blocked arteries can help with heart failure. When other treatments have failed, a heart transplant may be necessary.

Lifestyle changes

Changes to a person’s lifestyle that can help treat heart failure include:

  • stopping smoking
  • reaching or maintaining a moderate weight
  • consuming less salt
  • exercising regularly
  • limiting alcohol consumption
  • maintaining a regular sleep schedule
  • finding healthy ways to manage stress
  • managing contributing risk factors, such as blood pressure

The following are frequently asked questions about left sided and right sided heart failure.

What happens when both sides of the heart fail?

This is called biventricular heart failure.

If both sides of the heart fail, a person can experience symptoms of both left and right sided heart failure, such as a buildup of fluid and difficulty breathing.

What are the stages of heart failure?

The American College of Cardiology, American Heart Association, and Heart Failure Society of America define four stages of heart failure: A, B, C, and D.

At stage A, a person is at risk of heart failure but does not experience symptoms or dysfunction of the heart’s pumping ability. Related health conditions can affect a person’s risk.

Stage B is pre-heart failure. A person’s heart has structural abnormalities or signs of dysfunction but does not experience symptoms at this stage.

Stage C refers to symptomatic heart failure. At this stage, a person experiences abnormal heart function and symptoms of heart failure.

Stage D refers to advanced heart failure. A person will experience significant symptoms and recurrent hospitalizations that impair quality of life despite treatment.

Heart failure may occur when the heart cannot pump blood forcefully or effectively enough to properly supply the tissues of the body.

Left sided heart failure is more common, and right sided heart failure usually occurs as a result of left sided heart failure.

Certain conditions, such as CAD and high blood pressure, have close links to heart failure. Other risk factors include obesity, diabetes, age, and family history.

Lifestyle strategies such as stopping smoking and maintaining a healthy weight can reduce some risk factors for heart failure.

A doctor may treat heart failure with medications or, in severe cases, surgery.