Left vs Right Sided Heart Failure, Differences in Signs, Symptoms

Left-sided heart failure or left ventricular failure (LVF)is a reduction in the output from the left ventricle. The pressure in the left atrium increases as the oxygen-rich blood from the lungs are backed up since the left ventricle is not pushing out this blood fast enough or efficiently.

Right-sided heart failure or right ventricular failure (RVF) is a reduction in the blood output from the right ventricle. The pressure in the right atrium may be decreased, normal or increased depending on the return of blood from the rest of the body.

Left-sided heart failure is more common than right-sided heart failure. With time, both left-side or right-sided heart failure will lead to reduced cardiac output from both ventricles (biventricular heart failure).

Between LVF and RVF Signs and Symptoms

Refer to Heart Failure Signs and Symptoms for more information of the symptoms of heart failure (LVF and RVF).

Signs/Symptoms Left-Sided Heart Failure Right-Sided Heart Failure
Pitting Edema (Legs, Hands) Mild to moderate. Moderate to severe
Fluid Retention Pulmonary edema (fluid in lungs) and pleural effusion (fluid around lungs). Abdomen (ascites).
Organ Enlargement Heart. Liver. Mild jaundice may be present.
Neck Veins Mild to moderate raised jugular venous pressure (JVP). Severe jugular venous pressure (JVP). Neck veins visibly distended.
Shortness of Breath Prominent dyspnea. Paroxysmal nocturnal dyspnea (PND). Dyspnea present but not as prominent.
Gastrointestinal Present but not as prominent. Loss of appetite. Bloating. Constipation. Symptoms are significantly more prominent than LVF

It is difficult to isolate LVF from RVF based solely on the severity of jugular venous pressure (JVP), peripheral edema, shortness of breath or gastrointestinal symptoms. These signs and symptoms may vary among individuals depending on a host of other underlying factors.

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