Symptoms for failure of the right side of the heart

[SK__0]

  My aunt has been bedridden for the past one month. The crisis started with pneumonia and was quite serious since she is a chronic asthma patient.
  Now the doctor says the lungs are clear but this has resulted in respiratory weakness and we have to keep supplying extra oxygen because she doesn't seem to be able to manage for more than a day without it. She has also stopped speaking and when conscious only nods or shakes her head to questions.
  About a week back the doctor said that the right side of her heart was not functioning properly. One of the reasons he cited was that her face was a bit swollen. He refuses to volunteer any more information.
   Is that a symptom ? Are there any other symptoms ?
  What is a heart murmer and how do we come to know about it without taking an ECG ?

[CCF Cardio MD - MTR]

Dear SK, thank you for your question.  Right heart failure occurs when the right ventricle becomes dysfunctional and venous blood backs up from the right side of the heart.  Common signs of right heart failure include swelling of the legs, abdomen, and liver from the pooled venous blood.  Right heart failure is most commonly caused by left heart failure (dysfunctional left ventricle) as blood backs up to the right side of the heart through the lungs.  Other causes include disorders of the pulmonary arteries that cause the pulmonary artery blood pressure to rise, congenital cardiac malformations, and diseases of the pericardial sac that covers the heart.  I'm sorry to hear about your aunt's condition, but from what you've written, I do not think it's clear that she currently has right heart failure.  Perhaps, you could speak with her physician again to determine if he truly thinks this disorder is present.  However, if her lungs have been significantly damaged by the pneumonia, the pulmonary pressures may have risen to cause sudden right heart failure.  Also, patients who are bed-bound are at risk for developing venous clots of the legs that can travel to the lungs to decrease the oxygenation of the blood and cause some of the symptoms your aunt has.  Thus, I think you should have an involved discussion with her physician to investigate these possibilities.  Next, heart murmurs are sounds of disordered blood flow in the heart that can be heart with a stethoscope.  When valves leak or are narrowed, the blood flow is turbulent and sounds are produced that can be heard.  The usual test that is used to confirm the cause of heart murmurs is an echocardiogram (ultrasound of the heart).  An ECG only records electrical activity of the heart and is not very useful for determining the cause of heart murmurs.  Some murmurs can be confirmed with just a stethoscope, depending on the quality of the sounds.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.