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right-sided heart failure

  Dear Doctor,
    Besides left-sided heart failure what are the causes, symptoms, and
  treatments for right sided heart failure.  Does an echo or ekg show
  right sided heart failure.  What about arterial blood gases?
  Thank you,
  Will Trout
  P.S.  The reason I ask is because my right ventricle measurement was larger
  in a current echo that in one six months ago.  Although it was still in
  the normal size range and the doctor indicated the echo had no abnormalities.
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1 Answers
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Avatar universal

Dear Will,
Causes of right heart failure, which as it sounds you do not have, are left heart failure, pulmonary hypertension, tricuspid valve disease, atrial septal defects and other congenital anomalies, severe lung disease, multiple pulmonary emboli, cardiomyopathy (alcohol, viral, infectious and idiopathic), and infiltrative disorders.
Symptoms of right heart failure(RHF) are mostly swelling of the lower extremities, fatigue, and the symptoms that relate to the particular cause of the right heart failure (such as shortness of breath in the case of pulmonary hypertension.)
Treatment of RHF is not easy but entails aggressive treatment of the known or suspected cause, as well as the usual heart failure medications (ace-inhibitor, diuretics, etc.)
The ecg is not specific enough to show heart failure alone, but since it is a map of the hearts electrical circuit, it can show strain of the right heart muscle and or impaired conduction of the electrical stimulus throught the right heart.
The echo is the test to evaluate right heart function, plus it gives information on potential etiologies (i.e. the echo is used to evaluate the pulmonary pressure, the functioning of the tricuspid valve, etc.
Arterial blood gas is a measurement of the oxygenation of the blood.  Since the right side of the heart is responsible for getting the blood to the lungs to be oxygenated, one can infer from the blood gas that there is a right heart problem, however one can not diagnose RHF from an arterial blood gas.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
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.


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