Right heart failure

If the muscles of the right heart in particular are affected by the weakness, other symptoms will result.The right half of the heart takes up the oxygen-poor blood from the entire organs and pumps it further into the lungs, where it is to be enriched with oxygen again. However, because the right heart is too weak to continue pumping the blood, it collects in the veins that supply it. This accumulation can also cause fluid to back up in the tissues.

This is particularly noticeable in the lower legs, especially in the area of the ankles (this is the region where water is most likely to remain due to gravity), where it accumulates and swells (leg edema). These swellings are accompanied by an increased risk of the skin of the affected areas drying out due to the increased tissue pressure. This can lead to the development of eczema (stasis eczema), which in the course of time can become real wounds, which then heal with difficulty due to the reduced blood circulation and should therefore not be underestimated.

But also some internal organs can accumulate water due to the backlog of blood and consequently swell. Often affected are the liver, which can lead to pain under the right costal arch, and the digestive organs, which manifests itself as loss of appetite, feeling of fullness and loss of function. Water can also accumulate in the abdominal cavity, which is known as ascites.

Many patients complain of an increased urge to urinate during the night (nocturia). This is due to the fact that, on the one hand, the blood flow to the kidneys increases when lying down and, on the other hand, the fluid that has accumulated in the tissues during the day can now drain off and must be excreted. If both halves of the heart are equally affected, this is called global heart failure.

This is the most severe form of cardiac insufficiency, as it involves the symptoms of both the right and the left ventricle. Those affected have a very limited quality of life and often suffer from cardiac arrhythmia, which can sometimes become life-threatening. They must be treated.

The New York Health Association divides cardiac insufficiency into 4 groups according to its severity (NYHA I to IV): Patients who have not yet shown any limitations are to be assigned to the NYHA I group. This means that they are still able to cope with stress and have no other symptoms. In stage NYHA II, slight deficits in physical performance are already apparent.

While everything is still normal at rest and under low exertion, heavier exertion (e.g. when climbing stairs or doing sports) can lead to shortness of breath, angina pectoris (a feeling of tightness in the area behind the sternum) or cardiac arrhythmia. Patients in the NYHA III group do not have any complaints at rest, but they do have symptoms even at very low physical exertion, such as when walking on a straight plane. NYHA IV-classified patients show the symptoms angina pectoris, cardiac arrhythmia and shortness of breath already at complete rest and are therefore bedridden.