Acute right heart failure: what you need to know

Pressure can build in the veins, while less blood reaches the lungs and the left side of the heart. Treatment depends on the cause and may involve oxygen support, medicines, careful fluid management and treatment of the trigger.

The right ventricle normally sends blood to the lungs. A sudden strain, abnormal rhythm, heart damage or another serious problem can prevent it from keeping up. Acute right heart failure may present with breathlessness, swollen legs or abdomen, fatigue, a fast heartbeat, dizziness, chest discomfort or cool, clammy skin.

Clinicians check blood pressure, oxygen level, heart rhythm and signs of fluid congestion. Blood tests, an electrocardiogram and heart imaging can help identify the cause and show how well the right ventricle is working.

New or rapidly worsening symptoms require urgent assessment. Sit upright if breathing is difficult, avoid exertion and have someone stay with you. Take prescribed heart medicines only as directed; do not take an extra dose or sharply increase fluids unless a clinician has specifically advised it.

Bring your medicines list and information about when symptoms began. Tell the care team about recent infection, chest pain, fainting, palpitations, missed medicines, changes in swelling and any previous heart or lung condition.

Call emergency services for severe breathlessness, blue or grey lips, fainting, confusion, crushing chest pain, coughing up blood or a sudden inability to speak in full sentences. These signs can reflect poor oxygen delivery or another time-critical heart or lung problem.

Seek same-day medical care for rapidly increasing ankle or abdominal swelling, much less urine than usual, persistent racing heartbeat, worsening breathlessness when lying down or marked weakness. Do not drive yourself if you feel faint or severely short of breath.

Ask what is straining the right side of your heart, which test results guide treatment, how your fluids and medicines will be adjusted, and which symptoms should bring you back urgently. Before leaving care, confirm whether you should track swelling, weight, blood pressure or breathing at home and when follow-up is due.