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Right & Left Sided Congestive Heart Failure
Author: Mag D
What is right and left sided congestive heart failure? What's the difference between systolic and diastolic heart failure? What causes your heart to fail?
Keep reading as I will answer these questions and more.
Right sided heart failure usually occurs after the left side of your heart fails to perform its functions optimally.
What happens when the right side of your heart fails? Your heart and veins become congested with blood or fluid. As this happens, your right ventricle become stressed and fails to perform its functions efficiently. This is called left ventricular failure.
The right ventricle fails to pump blood through the pulmonary artery into the lungs for gaseous exchange. See pulmonary and systemic circulation pathways for more.
Right ventricular failure happens due to low pressure in the right ventricle than the force required to pump blood into the lungs with contraction of the heart muscle or myocardium.
Over time, your heart gets congested because your right ventricle does not empty or fill blood efficiently. Subsequently, your veins and lungs will also be overloaded with blood (venous and pulmonary congestion).
Compensatory mechanisms will begin to compensate for the failing heart. In right side heart failure, the right ventricle compensates for high blood pressure in your arteries.
Once the compensation has reached its limit, the heart becomes less effective and the right ventricle fails to empty all the blood it received. If there's no emergency medical intervention at this point, congestive heart failure death may follow.
The following figure shows you how blood normally fills the four chambers of your heart. These are the right atrium, right ventricle, left ventricle and left atrium.
The human heart valves controls the filling and emptying of blood from the ventricles and prevent back flow of blood and congestion. If the heart valves fails to function efficiently, serious complications are likely to occur.
What Causes Right Sided Heart Failure?
There are several causes of right side congestive heart failure and may not be limited to the following:
- Failure of a weakened heart muscle (myocardium) to contract effectively
- Narrowed and malfunctioning heart valves
- Narrowed and ineffective functioning blood vessels-vein and artery
- High resistance of blood flow through the blood vessels in the lungs.
The heart muscle may become weak as a result of ischemia that occur after few heart attacks.
The flow of blood to the lungs can be resisted when the valve of the left ventricle of the human heart has undergone stenosis or is no longer functioning efficiently.
In left sided congestive heart failure, the left ventricle fails to perform its normal function.
The ability of the left ventricle to pump blood requires that its internal pressure be greater than that in the aorta, the biggest and first artery leading to systemic circulation.
When the left ventricle fails, your atrium dialates and the pulmonary blood pressure increases. Subsequently, the blood pressure in the right side of your heart also increases resulting in venous congestion of the systemic and pulmonary circulation.
What Causes Left Side Congestive Heart Failure? There are several causes of left sided heart failure. These are:
When your left ventricle fails, usually your lungs will be congested with fluid. As a result, pulmonary eodema and pleural effusion occurs, especially in chronic heart failure.
Left sided heart failure causes the amount of oxygen-rich blood insufficient to meet the demands of your body. Your body continuously requires a sufficient amount of oxygen-rich blood for tissue perfusion.
What happens when your oxygen supply does not meet the body's demands? When important circulatory system organs and all parts of your body are deprived of oxygen and nutrients, various circulatory systems problems.
The most common complications include a heart attack, which occurs when your coronary arteries are narrowed or blocked such that not enough blood can circulate from the heart to other parts of your body.
Once you have suffered a heart attack, your risk of experiencing more heart attacks and subsequently left sided congestive heart failure is higher.
What is compensated heart failure? What processes are involved in compensated heart failure?
In acute congestive heart failure, the body has little time to make compensatory changes. If the heart fails over a stretched time, there will be compensatory processes that occur. The goal of compensation processes is to maintain cardiac output and tissue perfusion of important organs.
Compensatory processes include the following:
- The cardiac muscle fibers enlarge and increase the stroke volume and cardiac output. This result in improved contraction of the heart. The stroke volume refers to the volume of blood pumped out after each contraction of the heart's ventricles. Cardiac output refers to a factor of stroke volume in liters and the heart rate in beats per minute;
- The walls of the heart also thicken allowing more contraction of the heart and thus increasing the cardiac output;
- Increasing the heart rate also increases cardiac output; and
- When the renal blood flow is decreased, the renin-angiotensin-aldosterone system gets activated.
Renin-angiotensin-aldosterone system plays an important role as a compensatory mechanism during congestive heart failure by regulating your blood pressure and water in your body.
How does this system work?. Renin, angiotensin and aldosterone are all hormones that your body secrete when necessary. When the volume of your blood is low, renin is secreted first by your kidney after which the production of angiotensin is stimulated.
There is an important enzyme that allows the conversion of angiotensin I to angiotensin II, which then acts as a vasocontrictor, which enables the blood vessels to constrict and increases peripheral resistance and blood pressure. This causes further strain on the failing heart and as such your blood pressure will have to be lowered.
The consequence of high blood pressure causes the secretion of aldosterone and your kidneys enable blood to re-absorp sodium and water.
Therefore, the compensation enables the failing heart to function and meet the demand of the body. This increases blood volume and cardiac output.
Click the link to read more about renin-angiotensin-aldosterone system.
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