The most prominent symptoms of right-sided heart failure are marked weakness, breathing difficulties, edema and ascites. Edema on the ankles (pedal edema), as well as ascites accompanied with hepatosplenomegaly are indicators of venous congestion, which is one of the main features of this condition [11]. Other symptoms may include abdominal pain, bloating, nausea and weight loss. In severe cases, where both left- and right-sided failure occurs, marked dyspnea and cyanosis may be observed. Clinical examination may reveal tachycardia, increased jugular venous pressure with sometimes visible distension, while a heart murmur may be observed during auscultation. To establish the severity of heart failure, the New York Heart Association (NYHA) classification system is used, and ranges from I (no limitations in daily or physical activity as a result of cardiac changes) to IV (symptoms occur at rest and any activity creates significant discomfort) [3].

• Inflammation

  Cardiac magnetic resonance (CMR) is the preferred investigation in the diagnosis of cardiac sarcoidosis, allowing assessment of myocardial inflammation and fibrosis, as well as function, in a manner not matched by other technologies. [ncbi.nlm.nih.gov]

  Repeated or ongoing inflammation of it causes stiffening and thickening and prevents the heart from expanding normally to pump. A thickened pericardium restricts the heart's ability to pump effectively. [grandtraversesurgery.com]

• Leg Swelling

  When standing, swelling occurs in the feet, legs, ankles, and abdomen. When lying down, swelling may occur in the back and abdomen. If fluid accumulates in the stomach or liver, you may feel nauseous or lose your appetite. [sharecare.com]

  As a result, the body's tissues swell. The swelling most commonly affects the legs. But it also can occur in other tissues and organs. When it occurs in the lungs, it causes breathing difficulty. [drugs.com]

  swelling for many decades and dyspnoea on exertion for few months, presented to the local emergency department complaining of unexpected fall. [academic.oup.com]

  Trouble breathing not related to being active New or increased swelling of your legs or ankles Swelling or pain in your abdomen Breathing trouble at night. [fairview.org]

  According to the Mayo Clinic, right-sided heart failure is marked by swelling of the lower extremities. This swelling is caused by fluid backup in the legs, feet, and abdomen. [healthline.com]

• Fever

  His vital signs were normal, including fever absence. There were no additional examination abnormalities. [austinpublishinggroup.com]

  Please click here to view the introductory pages of the dictionary Riehl’s melanosis रील मैलेनिनता Riemer and Tiemann’s reaction राइमन-टीमन अभिक्रिया Rift valley ferver virus रिफ्ट़ वैली ज्वर वाइरस riftvalley fever रिफ्टवैली ज्वर right anterior oblique [bharatavani.in]

  There was no predisposition for vegetation, like intravenous drug abuse or right sided catheterization in this case; there was also any history of fever. [pubs.sciepub.com]

  […] ability to pump blood efficiently, often a complication of other disorders Etiology Left-sided heart failure, COPD, emphysema, congenital heart disease, heart-valve disease, cardiomyopathy Precipitating factors ↑ Activity, ↑ fluids, ↑ salt intake, high fever [medical-dictionary.thefreedictionary.com]

  […] en nausea vomiting fever nosebleeds further heart attack or chest pain (recurrent ischaemia, reinfarction) heart failure shock due to heart failure inflammation of the lining around the heart (pericarditis) fluid in the lungs (pulmonary oedema) genitourinary [hu.glosbe.com]

• Surgical Procedure

  Keywords: Aneurysm, false • Heart failure • Cardiac surgical procedures Abstract Pseudoaneurysms of the ascending aorta, which are rare and life-threatening complications in cardiovascular surgeries, can be caused by the Bentall procedure. [jthc.tums.ac.ir]

  Surgical procedures Surgical procedures can also be used to treat CHF. [bme240.eng.uci.edu]

  Functional mitral regurgitation is common in dilated cardiomyopathy and up to 50% of symptomatic heart failure patients with severe regurgitation are not treated due to the high risk surgical procedure [5]. [austinpublishinggroup.com]

  If prescription medications fail, surgical procedures can be performed to return heart function. [lunginstitute.com]

  Various drugs, surgical procedures and implantation of devices that assist in normal cardiac functioning serve as appropriate treatment modalities. [symptoma.com]

• Disability

  Please enable JS and disable any ad blocker [cardio-online.fr]

  Heart failure has a tremendous economic impact on the U.S. healthcare system because of direct medical costs, disability and loss of employment. Estimated treatment costs in 1994 were $38 billion, of which $23 billion were spent on hospitalizations. [emsworld.com]

  "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". [en.wikipedia.org]

• Overeating

  If it’s not treated, it could weaken your heart over time. Lung disease. Over time, problems in the lungs cause the right side of the heart to enlarge and fail. Your doctor may call this “cor pulmonale.” Other long-term health conditions. [webmd.com]

  This leads to pressure buildup behind the left side of the heart that, over time, causes the right side of the heart to fail. [grandtraversesurgery.com]

• Nausea

  Cardiology (Cardiovascular Disease) The symptoms of right-sided heart failure include lower-extremity edema (swelling), abdominal bloating, nausea and fatigue. [sharecare.com]

  Signs and symptoms Oedema (swelling) especially in the ankles, shins or lower back Nausea & vomiting Abdominal pain and distension Lethargy and tiredness Management This is a chronic condition which needs managing by a medical professional. [firstaidforfree.com]

  […] a heart attack or severe angina, that s being treated in hospital if you have heart failure, or have had heart failure in the past if you have liver disease if you have had diabetic ketoacidosis (a complication of diabetes causing rapid weight loss, nausea [hu.glosbe.com]

  […] permanent atrial fibrillation and ischemic dilated cardiomyopathy with New York Heart Association (NYHA) class 2 heart failure was hospitalized due to one-month history of worsening of bilateral leg edema, abdominal right upper quadrant discomfort with nausea [austinpublishinggroup.com]

  Symptoms that the patient may complain about are fatigue, anxiety, depression, dependent edema of the lower extremities, anorexia and nausea (Lewis, et al, 2011). [sites.psu.edu]

• Loss of Appetite

  Cardiology (Cardiovascular Disease) Symptoms for right sided heart failure are related to fluid buildup in the body: - swelling in the feet and legs ( edema ) when standing - swelling in the back when lying down - nausea - loss of appetite Right-sided [sharecare.com]

  Loss of Appetite Fluid accumulation in the digestive organs can cause you to feel full. You may also feel bloated. You may want to try eating smaller more frequent meals instead of the traditional three large meals a day. [heartfailure.org]

  Loss of appetite results from venous engorgement and venous stasis within the abdominal organs. Prevention Prevention of heart failure mainly lies in lifestyle management. Healthy diet. [nurseslabs.com]

  Fluid accumulation in the liver or stomach can cause nausea, bloating, and loss of appetite. Severe right-sided heart failure can result in loss of weight and muscle. This condition is called cardiac cachexia. [msdmanuals.com]

• Heart Failure

  Abstract The Canadian Cardiovascular Society published a comprehensive set of recommendations on the diagnosis and management of heart failure in January 2006. [ncbi.nlm.nih.gov]

  Right Heart Failure According to authors of an April 2008 article in "Circulation," left heart failure is the most common cause of right heart failure. [livehealthy.chron.com]

• Hypertension

  Primary pulmonary hypertension carries a grim prognosis, therefore, it is imperative that prior to reaching this diagnosis, a thorough search be made for all possible causes of pulmonary hypertension. [ncbi.nlm.nih.gov]

  WHO Classification of Pulmonary Hypertension Pulmonary arterial hypertension Pulmonary venous hypertension Pulmonary venous hypertension associated with hypoxaemia (eg COPD) Pulmonary hypertension due to chronic thrombotic or embolic disease Miscellaneous [rcemlearning.co.uk]

  Pulmonary hypertension, like arterial hypertension, is a phenomenon of diverse causes that include both increases in flow and in resistance across the pulmonary vascular bed. [onlinejacc.org]

• Chest Pain

  For example, a patient who presents to the ED with chest pain may be having an acute myocardial infarction for which sublingual glyceryl trinitrate (GTN) is appropriate; however if a patient with chest pain also has RV failure as a complication of PH, [rcemlearning.co.uk]

  Other common causes of chest pain unrelated to the heart are chest muscle, bone or joint disease, and acid in the esophagus. Weight Gain or Loss Excess fluid in the body may cause an increase in weight. [heartfailure.org]

  Call 911 Call 911 if you: Become severely short of breath Feel lightheaded, or feel like you might pass out or faint Have chest pain or discomfort that's different than usual, the medicines your provider told you to use for this don't help, or the pain [fairview.org]

  Class IV (Severe) : You experience shortness of breath with any physical activity and when sitting or resting, you may feel fatigue, cough, shortness of breath and chest pain. [sjm.com]

  These include: Abdominal bloating or discomfort Persistently pale skin Poor appetite Always take chest pain seriously. Congestive heart failure, per se, usually does not cause chest pain. [emedicinehealth.com]

• Hypotension

  […] presentation Mechanisms of clinical manifestations: Decreased CO, fluid retention, atrial/ventricular arrhythmias Complications: Congestive hepatopathy/cardiac cirrhosis Symptoms Fatigue & exercise intolerance Peripheral edema, ascites, weight gain P/E Vitals: Hypotension [nerdcat.org]

  Inhaled milrinone has also been investigated for management of RHF as it avoids the side effect of systemic hypotension. [escardio.org]

  […] dilates when the dilation maximised -> reversal of the ventricular septal gradient with abnormal septal movement, rising atrial pressures and TR this eventually produces a global reduction in left sided preload -> systemic coronary perfusion and systemic hypotension [lifeinthefastlane.com]

  A nitroglycerin infusion in a hypotensive heart failure patient may be accomplished through concurrent administration of a positive inotrope. [emsworld.com]

  However, rapid and excessive diuresis may precipitate systemic hypotension and renal insufficiency (1). Spironolactone, an aldosterone antagonist that is of benefit in patients with left-heart failure, is also used to treat right-heart failure (1). [rcemlearning.co.uk]

• Vascular Disease

  […] hypoxemia and pulmonary thromboembolic and venoocclusive disease, collagen vascular disease, portal hypertension, HIV infection as well as pulmonary hypertension secondary to drugs and toxins. [ncbi.nlm.nih.gov]

  However, the prevalence of PH is thought to be much higher than reported in developing countries where diseases that may promote pulmonary vascular disease (schistosomiasis, sickle cell disease, human immunodeficiency virus infection, liver cirrhosis [rcemlearning.co.uk]

  In fact, left-heart failure is the most common cause of right-sided heart failure, while congenital heart disease, infection of heart valves (endocarditis), vascular diseases such as hypertension, myocardial infarction (heart attack) and numerous other [symptoma.com]

  Anatomical disruption of the pulmonary vascular bed due to primary lung disease (for example, in emphysema, pulmonary thromboembolic disease and pulmonary fibrosis). [patient.info]

  Dyslipidemia Coronary/peripheral vascular disease Sleep-disordered breathing Collagen vascular disease, rheumatic fever Pheochromocytoma Thyroid disease Substance abuse (previous/current history) History of chemotherapy/radiation to the chest The New [emedicine.medscape.com]

• Stroke

  The decrease in preload will reduce the amount of blood ejected with each contraction (stroke volume). The decrease in preload and stroke volume will cause a reduction in cardiac output. [emsworld.com]

  Arrhythmias and atrioventricular conduction disturbances should be appropriately treated to maintain stroke volume of the right and left ventricles. Prevention of low cardiac output is mandatory. [onlinejacc.org]

  Anticoagulants - these drugs make it harder for the blood to clot; they help thin the blood and help prevent a stroke. The most commonly used anticoagulant is Warfarin. [medicalnewstoday.com]

  "Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee". Circulation. 117 (4): e25–146. doi : 10.1161/CIRCULATIONAHA.107.187998. [en.wikipedia.org]

  Narrowing of the blood vessels limits the blood supply and can contribute to conditions such as stroke, heart disease and clogged or blocked blood vessels in the legs and other parts of the body. [ucsfhealth.org]

• Nocturia

  […] resistance in lungs Signs & Symptoms of Right-Sided Heart Failure -Jugular vein distention -Anorexia -N/V -Abdominal distention -Ascites -Hepatomegaly -Dependent edema, peripheral edema -Weight gain -Signs of left-sided heart failure -Tachycardia -Fatigue -Nocturia [quizlet.com]

  Symptoms that the patient may complain about are weakness, fatigue, anxiety, depression, shortness of breath, shallow, fast respirations, dry, hacking cough, nocturia and paroxysmal noctural dyspnea (Lewis, et al, 2011). [sites.psu.edu]

  D: Nocturia is not present in heart failure. 4. Answer: A. Stage I A: Stage I refer to a patient who reports no symptoms of heart failure at rest but becomes symptomatic with increased physical activity. [nurseslabs.com]

  Nocturia and oliguria Nocturia may occur relatively early in the course of heart failure. Recumbency reduces the deficit in cardiac output in relation to oxygen demand, renal vasoconstriction diminishes, and urine formation increases. [emedicine.medscape.com]

  Nocturia (frequent nighttime urination) may occur when fluid from the legs is returned to the bloodstream while lying down at night. [en.wikipedia.org]

• Renal Insufficiency

  Causes of constrictive pericarditis included idiopathic (52%, n = 36), tuberculosis (9%, n = 6), postcardiotomy (12%, n = 8), radiation (4%, n = 3), renal insufficiency (12%, n = 8), and autoimmune disease (12%, n = 8). [ncbi.nlm.nih.gov]

  However, rapid and excessive diuresis may precipitate systemic hypotension and renal insufficiency (1). Spironolactone, an aldosterone antagonist that is of benefit in patients with left-heart failure, is also used to treat right-heart failure (1). [rcemlearning.co.uk]

  The prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. J Am Coll Cardiol. 2000 Mar 1. 35 (3):681-9. [Medline]. [emedicine.medscape.com]

A thorough clinical examination and a good patient history may provide vital clues that determine the course of workup in these patients. Initial studies should comprise ECG, chest X-ray and laboratory studies including CBC, liver and kidney function tests, serum electrolytes and brain natriuretic peptide (BNP). If the symptoms appeared abruptly, cardiospecific enzymes should be evaluated as well. Chest X-ray may reveal pulmonary edema or an increased cardiac silhouette, whereas ECG studies provide a good view into the cardiac conduction system. To make a definite diagnosis, echocardiography is the optimal imaging study, which provides an excellent view into the cardiac structures [12]. Additional techniques that may be of use to establish the overall condition of the patient are CT and MRI, while 3D echocardiography is showing promising results in replacing invasive methods for determination or right atrial pressure [13].

To effectively treat right-sided heart failure, resolution of the underlying cause is a must [1]. During the diagnostic workup, however, symptomatic therapy and correction of blood pressure and tissue oxygenation must be carried out, usually with the help of various pharmacologic agents. Digoxin, β-blockers, calcium-channel antagonists, diuretics, ACE inhibitors, aldosterone blockers and several other groups are all used under various circumstances [3]. Changes in dietary habits may be of particular importance, especially reduction in sodium intake, as it is shown to be a very important factor in the pathogenesis of atherosclerosis and other cardiovascular diseases, including MI. Directed therapy may be initiated in the case of endocarditis, where various antibiotic regimens exist, depending on the underlying pathogen, while congenital heart disease is usually treated surgically. Thrombolytic therapy is indicated in the setting of pulmonary embolism, whereas invasive cardiac surgery is required for patient with MI. Sometimes, despite after recommended treatment, heart failure may persist and require implantation of various devices. Defibrillators or pacemakers may be inserted and are used as a last resort in treating heart failure.

The outcome of patients with right-sided heart failure is not good, since its presence is shown to correlate with a poor prognosis [8]. A 50% overall mortality rate 4 years after making the diagnosis shows how dangerous heart failure is [6]. Mortality rates significantly depend on the underlying condition, however, since some diseases can be almost completely cured and pathophysiologic changes in the right heart can be almost fully reversed.

Causes of right-sided heart failure may be numerous, but the most common is left-sided heart failure, which puts immense pressure on the pulmonary vasculature and consequently on the right ventricle. Other causes include [5] [6]:

• Lung diseases - Chronic obstructive pulmonary disease (COPD), pulmonary embolism, cystic fibrosis, as well as chest wall dysfunction all lead to development of pulmonary edema and profound hypertension, thus creating conditions for cor pulmonale.
• Cardiovascular disease - Hypertension, coronary artery disease (CAD) and myocardial infarction (MI) can cause significant changes in blood flow and oxygen delivery into cardiac myocytes and cause rapid heart failure.
• Cardiomyopathies - Restrictive, dilatative and and hypertrophic cardiomyopathy exert marked changes on the right ventricle and often lead to heart failure.
• Valvular heart disease - In the setting of tricuspid or pulmonic stenosis, usually as a result of endocarditis, significant effort by the right heart is needed to achieve adequate output when combating increased resistance through the affected valves.
• Congenital heart disease - Ebstein malformation and right-to-left shunts such as tetralogy of Fallot and transposition of great arteries cause significantly higher pressures in the right ventricle.
• Endocrine disorders - Thyroid abnormalities, adrenal insufficiency, pheochromocytoma and diabetes mellitus are also known to be involved as causes of heart failure.

Various other factors, including iatrogenic, nutritional (obesity, selenium or thiamine deficiency), environmental (heavy alcohol consumption), infectious (Chagas disease), end-stage renal disease and several other have shown their properties in initiating heart failure [5].

Because of significant advances in medical care that have enabled a longer life expectancy, incidence and prevalence rates of heart failure have risen in the past few decades [5]. Rough estimates suggest that the prevalence rate of heart failure in general is between 1-2% in countries of the Western world, while an incidence rate is established to be approximately 5-10 per 1000 individuals [7]. Prevalence rates are shown to rise abruptly after 70 years, showing that between 10-20% of individuals over 70 years develop heart failure, indicating that advanced age is a significant factor [6]. In the United States, approximately 5 million individuals are affected by this condition and incidence rates indicate that more than 500,000 cases occur every year [3]. Exact prevalence rates of right-sided heart failure are not formed yet, but it is one of the most important predictors of mortality in heart failure [8]. Namely, heart failure that is caused by MI and several other causes has substantially different outcomes depending on the presence or absence of right-sided heart failure [8].

The pathogenesis of right-sided heart failure is complex and various pathological events occur simultaneously. Through the inferior vena cava and the portal vein, the venous circulation drains into the right atrium. During diastole, blood is pooled into the right ventricle and then forced into the pulmonary circulation during systole. Depending on the underlying condition that affects the right heart, various mechanisms contribute to eventual failure. In the case of MI, sudden cessation of blood flow leads to hypoxia, myocardial necrosis and fibrosis, thus reducing the viability of myocardial cells to perform their function. In endocarditis, stenosis of pulmonary or tricuspid valve necessitates a greater contractile force to combat higher resistance. Pulmonary hypertension, however, is one of the most significant factors in the development of right-sided heart failure, which occurs in the setting of left-sided heart failure and various lung diseases [9]. The right heart is unable to overcome increased resistance in the pulmonary vasculature and the end-result, regardless of the cause, is inadequate tissue oxygenation and diffuse hypoxia. In order to restore adequate oxygen supply to tissues, various compensatory mechanisms are activated. Cardiac remodeling, increased oxygen extraction from tissue, changes in systemic circulation and hormonal stimulation are some of the most important [3]. Right ventricular hypertrophy and dilation occurs to maximize output, while upregulation of sympathetic tone results in increase heart rate. The renal system triggers the renin-angiotensin-aldosterone system that contributes by retention of salt and water. However, all of these effects can cause significant damage to the heart if the condition that led to activation of these mechanisms is not resolved. More importantly, the right heart is not able to sustain such powerful stimulation for longer periods [10]. Over time, progressive deterioration of right heart function, leading to irreversible fibrosis of myocytes with both systolic and diastolic dysfunction.

Various steps can be made to prevent the onset of heart failure. Firstly, proper management of various conditions that may precipitate heart failure is vital, while dietary habits that include low sodium intake may significantly reduce the risk for developing cardiovascular diseases in general. The diagnosis of heart failure in early stages is proven to significantly prolong survival, which is why a thorough workup by the physician may ultimately save a patient's life.

Right-sided heart failure is a clinical entity that occurs as a result of various conditions that impair right heart function, resulting in reduced output and volume overload [1]. Left-sided heart failure is the most common cause, most likely as a result of pulmonary edema, eventually leading to an acute right heart failure known as cor pulmonale. Myocardial infarction, endocarditis affecting either tricuspid or pulmonary valves, congenital heart disease (right-to-left shunts), Ebstein malformation, as well as various forms of cardiomyopathy have all been described as precipitating factors of right-sided heart failure [2]. Under physiological circumstances, the entire venous system is drained into the right atrium, from where it travels into the right ventricle and eventually into the pulmonary circulation. Abnormalities in pulmonary circulation (such as hypertension as a result of left-heart failure), deficient right ventricle contractility (cardiomyopathy, endocarditis) and impaired either systolic and/or diastolic function of the right heart leads to reduced cardiac output and tissue oxygenation [3]. Because hypoxia of various organs may occur, several compensatory mechanisms are activated, including dilation and hypertrophy of the right ventricle, activation of the sympathetic system that results in increased contractility and heart rate acceleration, salt and water retention from the kidneys and blood flow changes [4]. However, as the cause is either not resolved or the onset of heart failure is acute and sudden, these compensatory mechanisms cause more harm than benefit, which may lead to irreversible changes in cardiac myocytes, mainly apoptosis, collagen deposition and fibrosis of the cardiac muscle. In the case of right-sided heart failure, the end-result is reduced movement of venous circulation that leads to congestion, portal hypertension, development of ascites and hepatosplenomegaly. Consequently, one of the main clinical presentations of patients with right-sided heart failure is peripheral edema, especially of the extremities and ankles (known as pedal edema), usually accompanied with diffuse weakness and dyspnea. Because of venous congestion in the gastrointestinal system, abdominal discomfort, bloating and weight loss may be reported as well. Clinical examination may reveal tachycardia (and in case of endocarditis, a heart murmur may be noted on auscultation), lower oxygen saturation, enlarged liver and spleen and elevated jugular venous pressure. Workup should include laboratory studies such as complete blood count (CBC), liver transaminases, cardiospecific enzymes (in case symptoms appeared abruptly), urine function tests (blood urea nitrogen and creatinine), serum electrolytes, brain natriuretic peptide levels and albumin count. Plain radiography is a simple and easy diagnostic method that may identify signs of heart failure, while electrocardiography (EKG), echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI) are useful techniques to identify the underlying cause responsible for heart failure. Treatment is aimed at resolving the condition that caused heart failure, but it is not always possible. Symptomatic therapy, dietary changes and in some cases, device implantation is necessary. Heart failure has a poor prognosis if the disease that caused it is not treated. For these reasons, finding the cause is imperative in achieving good outcomes.

Right-sided heart failure is a clinical syndrome that describes failure of either the right atrium and/or right ventricle as a result of various diseases. It may occur as a separate condition, where marked changes in structure of these heart chambers are observed, or it may occur together with left-sided heart failure. In fact, left-heart failure is the most common cause of right-sided heart failure, while congenital heart disease, infection of heart valves (endocarditis), vascular diseases such as hypertension, myocardial infarction (heart attack) and numerous other conditions may trigger this pathological event. Right-sided heart failure often develops as a result of increased pressures in the blood vessels of the lungs (known as pulmonary hypertension), where the right heart should pump blood that arrived from all the veins in the body. Additionally, various conditions within the right heart can significantly harden its function. The end-result is a need for increased effort of the right heart to pump the blood into the lungs, which is achieved by activating several compensatory mechanisms. The heart enlarges its chambers and increases muscle size and strength, neural networks that increase the velocity and the strength of the heart are stimulated and the kidneys attempt to decrease blood flow through them while savoring water and salts to compensate for blood pressure changes. These actions are effective in short-term circumstances, but since heart failure is considered to be the end-stage disease of the heart, these mechanisms persist for a prolonged period of time and eventually start to actually harm the individual and cause further deterioration.

Once right-sided heart failure occurs, the main feature is reduced velocity of blood flow through the venous system, manifesting as swelling of the extremities, particularly ankles, liver and spleen enlargement, together with extreme fatigue that occurs due to insufficient oxygen delivery by the damaged heart. To make the diagnosis, various imaging and laboratory studies need to be carried out. Chest X-ray, electrocardiography and often echocardiography are required, while various blood tests including serum electrolytes, liver and kidney function tests, as well as levels of proteins in blood are necessary to evaluate the status of various organs. It is important to find the underlying disease that is responsible for right-sided heart failure, as treatment success solely depends on managing the cause.

Depending on the condition responsible, various therapeutic approaches exist. Usually, symptomatic management is necessary in initial stages before the cause is determined, after which directed treatment may be initiated. Various drugs, surgical procedures and implantation of devices that assist in normal cardiac functioning serve as appropriate treatment modalities. It is estimated that more than 5 million people in the United States suffer from heart failure and more than 500 000 new cases occur every year. Moreover, it was observed that approximately 2-3% of people in the Western world have this condition, with the majority being over 75 years of age. When taking into consideration the fact that the survival rate 4 years after the diagnosis of heart failure is 50%, the significance of this condition must not be undermined. In fact, an early diagnosis of the underlying condition may be lifesaving for the patient, but much can be done in terms of prevention. Reduced sodium intake through diet, cessation of heavy alcohol consumption and smoking (well-known factors for atherosclerosis) and ensuring long-term patient care can reduce the burden of this condition in a significant manner worldwide.

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