What are the Right Heart Failure Symptoms?

There are several right heart failure symptoms that give you a swift warning sign that it is impending or that you have encountered it. Some of these symptoms are obvious, whereas others are underlying. Let’s discuss all these symptoms one by one in detail: 

• Swelling (Edema): One of the hallmark symptoms of right heart failure is swelling, or edema. This typically occurs in the lower extremities, such as the legs, ankles, and feet. Swelling results from the buildup of fluid in the tissues due to the heart’s inability to pump blood effectively. In more advanced cases, swelling can also occur in the abdomen, leading to a condition known as ascites.
• Shortness of Breath: While shortness of breath is more commonly associated with left-sided heart failure, it can also be a symptom of right heart failure. This occurs because fluid can accumulate in the lungs (a condition known as pulmonary hypertension), making it difficult to breathe. Patients may experience difficulty breathing during physical activity or even at rest.
• Fatigue and Weakness: As the heart struggles to pump blood efficiently, the body’s tissues and organs receive less oxygen and nutrients. This can result in chronic fatigue and a general feeling of weakness. Patients with right heart failure often find that they tire easily and struggle to perform everyday activities that they once did with ease.
• Increased Urination at Night (Nocturia): Nocturia, or frequent urination at night, is another symptom of right heart failure. This occurs because fluid that accumulates in the lower extremities during the day returns to the bloodstream and is processed by the kidneys when the patient is lying down. This can lead to an increased need to urinate during the night, disrupting sleep.
• Heart Palpitations: Patients with right heart failure may experience heart palpitations or the sensation of a racing or irregular heartbeat. This can occur as the heart tries to compensate for its decreased pumping ability. Palpitations can be unsettling and are often accompanied by dizziness or lightheadedness.
• Abdominal Discomfort or Bloating: Right heart failure can cause blood to back up into the veins that deliver blood to the human heart, including those in the abdomen. This can lead to congestion in the liver and gastrointestinal tract, resulting in abdominal discomfort, bloating, and a feeling of fullness. In some cases, this can also lead to a loss of appetite and subsequent weight loss.
• Jugular Venous Distention (JVD): Jugular venous distention is a physical sign of right heart failure where the jugular veins in the neck become visibly swollen. This occurs because the increased pressure from the failing right heart causes blood to back up into these veins. JVD is often noticeable when a patient is lying down or sitting at a slight incline.
• Coughing and Wheezing: Although less common, coughing and wheezing can occur in right heart failure. These symptoms are typically due to the buildup of fluid in the lungs, leading to congestion and irritation of the airways. Persistent coughing or wheezing should not be ignored and warrants medical evaluation.
• Cyanosis: Cyanosis, or a bluish tint to the skin and mucous membranes, can occur in severe cases of right heart failure. This is a sign that the blood is not being oxygenated adequately, and it often appears in the lips, fingers, and toes. Cyanosis indicates a critical decrease in oxygen levels and requires immediate medical attention.