What should you know about right ventricular heart failure?

The right ventricle receives blood from the body and sends it to the lungs. If it becomes weak or has to pump against high pressure, blood backs up in the veins. This may cause swollen ankles, leg swelling, abdominal fullness, weight changes from retained fluid and breathlessness. Fatigue can develop because less blood reaches the tissues. Right-sided failure may occur with left-sided heart failure, lung disease or high pressure in the lung arteries. Heart rhythm problems such as atrial fibrillation and long-standing hypertension can add strain, but symptoms alone cannot identify the cause.

Arrange a clinical review if swelling, reduced exercise tolerance, breathlessness or palpitations are new, persistent or worsening. Assessment may include listening to the heart and lungs, checking blood pressure and oxygen level, reviewing medicines, and arranging tests such as an electrocardiogram, blood tests or an echocardiogram. Treatment depends on the cause and may include medicines, management of lung or heart disease, and a plan for monitoring fluid symptoms. Do not change prescribed heart medicines or start diuretics without medical advice. A chronic disease review can help coordinate follow-up.

Seek emergency help for severe or rapidly worsening breathlessness, chest pressure, fainting, new confusion, blue or grey lips, or an inability to lie flat because of breathing difficulty. Urgent assessment is also needed for sudden one-sided leg swelling with chest symptoms, or a fast irregular heartbeat accompanied by weakness, dizziness or breathlessness. These warning signs can have several causes and should not be judged by the amount of ankle swelling alone.

Ask which part of the heart or lungs is causing the strain, whether an echocardiogram is needed, how to track swelling and breathlessness at home, and which medicines or salt and fluid instructions apply to you. Clarify what change should prompt a same-day call and when your next review is due.