The heart is made up of four chambers, with the lower 2 chambers referred to as the ventricles and the upper two as the atria. The atria or the upper 2 chambers are responsible for receiving blood into the heart and directing it to the ventricles. It then pumps the blood out through the arteries to various parts of the body. Each half of the heart, divided vertically will, therefore, have one ventricle and one atrium.
When thinking about the heart, the left and right sides are named from a first-person perspective. This means that the right ventricle and atrium are the ones on my right - hand side. The right side of the heart is responsible for receiving deoxygenated blood. The right atrium receives blood first, directs it to the right ventricle which pumps the blood to the lungs.
When this blood returns from the lungs, it enters the left atrium to the left ventricle which then pumps blood to the entire body.
As you can already tell, the left ventricle does a lot more work than the right ventricle. The left-side pumps blood to the entire body and the right ventricle only pumps blood to the lungs. For this reason, the left ventricle not only consists of thicker muscles but also receives the most attention from doctors and cardiac diseases.
When is the right ventricle considered to have failed?
Nevertheless, the right ventricle can still experience failure, just like its left counterpart. The right ventricle is considered to be in failure if it does not perform its function properly. Normally, the right ventricle is smaller in volume compared to the left ventricle.
When the opposite is identified through an angiogram, this is considered as the right ventricular failure. It occurs when the right ventricle can’t pump up blood effectively to the lungs, so it becomes enlarged, and its muscles thicken to cover the deficit in pressure.
Causes of right ventricular failure
Pulmonary heart disease
This is a condition whereby the right ventricle becomes enlarged and its muscles thickened to adequately pump blood to the lungs. This is caused when there is increased pressure in the lungs that prevents blood from flowing smoothly through the lungs.
The increased pressure in the lungs could be due to a pulmonary disease like a lung disease, sarcoidosis, sickle cell anemia or blood clots in the lungs. To counter this increased pressure, the right ventricle has to become larger and its muscles thicker, to ensure that the blood is pumped at the required pressure.
Although heart failure often affects the left ventricle, its effects can reach the right ventricle too. When the left ventricle is unable to keep up with the right ventricle’s blood flow, it begins to cause increased pressure in the pulmonary vein. This subsequently causes increased pressure in the pulmonary artery and the right ventricle.
When blood stops flowing into the right ventricle, perhaps due to blood clots in the veins, the muscles of the right ventricle will be destroyed. That means they can’t function properly, thus, leading to a right ventricular failure.
Signs and symptoms of right ventricular failure
Common sign and symptoms of right ventricular failure include:
• Shortness of breath,
• Irregular heartbeat,
• Heart palpitation,
• Pronounced veins of the neck,
• Swelling of the feet and ankles,
• Frequent urination at night, etc.
How is right ventricular failure treated?
Heart failure requires constant monitoring and examinations from your health care provider. After developing heart failure, constant and repeated hospitalizations are necessary. The goal of the treatment is to control the signs and symptoms, reduce the heart’s workload and improve the heart’s ability to function normally. The treatment is also focused on maintaining and keeping under control any underlying disorder that has led to a right ventricular failure in the first place.
In cases of abnormal ECG and rhythm problems, a biventricular pacemaker is necessary. Other patients benefit from valve replacement surgeries or bypass surgeries. Medications commonly used for the treatment of right ventricular failure include diuretics, ACE inhibitors, ARBs, beta – blockers, digitalis, etc. In cases of severe heart failure, the only solution is a heart transplant.
Complications of right ventricular failure
Possible complications include:
• Abnormal heart rhythms, which can be even life – threatening,
• Repeated hospitalizations,
• Cardiac arrest,
• Sudden death.
Outlook for right ventricular failure
Heart failure is a serious medical condition which requires immediate medical help and hospitalization. There is no cure for heart failure. However, many forms of heart failure can be successfully maintained, kept under control with various medications.
If the underlying condition that has led to the right ventricular failure in the first place is kept under control, the heart failure will also be successfully maintained and under control.