Why is the right side of the heart weaker?
The left side of your heart pumps fresh blood to the rest of your body through your circulatory system. The left ventricle is larger and stronger than the right because it has to pump blood through your whole body.
Left-sided heart failure is the most common type. Right-sided heart failure: Here the right ventricle of the heart is too weak to pump enough blood to the lungs.
Generally, heart failure begins with the left side, specifically the left ventricle — your heart's main pumping chamber. Fluid may back up in the lungs, causing shortness of breath.
- shortness of breath, especially when lying flat.
- coughing.
- dizziness.
- difficulty concentrating and confusion.
- fatigue and low energy.
- sudden weight gain.
- reduced appetite.
- upset stomach.
This is because the heart's bottom-left chamber (the 'left ventricle') is responsible for pumping oxygenated blood around the whole body, so it needs to be stronger and larger than the right ventricle, which only pumps blood to the lungs. It's this left ventricle that you can feel beating in your chest.
The right side of the heart usually becomes weaker in response to failure on the left side. The right side of the heart brings in the circulated blood from the body and sends it to the lungs for oxygen. When the left side of the heart weakens, the right side of the heart has to work harder to compensate.
It includes emphysema, pulmonary embolism, and other causes of pulmonary hypertension. High blood pressure in the pulmonary arteries increases the workload of the right ventricle. Over time, this causes the right ventricle to fail. This is blockage of the arteries that supply blood to your heart.
Right-sided heart failure is almost always caused by a problem with the left side of your heart. When the left ventricle fails, excess fluid pressure flows back through the lungs, eventually damaging the right side of your heart.
Pulmonary hypertension is the commonest cause of right heart failure. Other causes are RV myocarditis, genetic cardiomyopathy, ischaemia ,as well as pericardial disease.
Left-sided heart failure is more common than right-sided heart failure and is caused by dysfunction of your left ventricle. It most often occurs due to coronary heart disease, heart attacks, or long-term high blood pressure. Left-sided heart failure can cause right-sided heart failure.
What is the treatment for right heart failure?
Treatment should include rapid optimisation of volume status, restoration of perfusion pressure and improvement of myocardial contractility and rhythm, and, in case of refractory RV failure, mechanical circulatory support.
So when you have right-side heart failure, the right chamber has lost its ability to pump. That means your heart can't fill with enough blood, and the blood backs up into the veins. If this happens, your legs, ankles, and belly often swell.

Right-sided CHF - Right-sided CHF develops when the right ventricle struggles to deliver blood to the lungs. As blood backs up into the blood vessels, the body begins to retain fluid in the abdomen and lower body.
Left-sided heart failure occurs when the heart loses its ability to pump blood. It often happens in people with high blood pressure and certain heart conditions. You may experience systolic heart failure or diastolic heart failure. Treatment can boost your heart's pumping ability.
The left ventricle is the largest and strongest chamber in your heart. The left ventricle's chamber walls are only about 1.0 to 1.3cm, but they have enough force to push blood through the aortic valve and into your body.
The right side of your heart receives oxygen-poor blood from your veins and pumps it to your lungs, where the blood picks up oxygen and gets rid of carbon dioxide. The left side of your heart receives oxygen-rich blood from your lungs and pumps it through your arteries to the rest of your body.
The right side of the heart collects oxygen-depleted blood from the body and brings it to the lungs to be filled with fresh oxygen. The left side of the heart receives oxygen-rich blood from the lungs and sends it out to the rest of the body.