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Symptoms of right sided heart failure

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Tanner Marshall.

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Video transcript

- [Voiceover] So we know that the symptoms of heart failure can be a little different depending on which side of the heart we're talking about. If we're gonna talk about the right side, we're talking about the side that deals with the blood that's just been used by the body, and so it has less oxygen or we call it deoxygenated blood. So this blood comes into the right side and then it's pumped to the lungs where it can get more oxygen there, and it can get reoxygenated. And if we have right-sided heart failure, this means that the heart doesn't pump as much blood as it should to the lungs. And so the symptoms that result are going to be a little different for this type than when we talk about left-sided failure where it pumps it to the body. What is similar though, is that we can talk about both forward and backward failure symptoms. And let's just remember that forward failure means that these symptoms revolve around the right side's ability to pump blood out of the heart to the lungs. And when we say backward failure we're talking about the symptoms that result from this backup of blood that's trying to get into the heart. And this time it's in the right side, so it's coming from the body. So starting with forward failure, just like in the left side weakness and fatigue is gonna be a major symptom. But it comes about slightly differently. So the right side's responsible for pumping blood to the lungs that's been used up by the body. So in other words there's less oxygen and more carbon dioxide. Usually you'd want this blood pumped to your lungs to have that carbon dioxide exchanged for oxygen, so it's like your trading the carbon dioxide for oxygen. But when it's not pumping as much blood, that means there isn't as much of this exchange of carbon dioxide for oxygen, and so the body receives less oxygen and this is felt, just as before, as tiredness, weakness, and fatigue since your body needs oxygen and it doesn't need carbon dioxide. And when your body doesn't receive as much oxygen, what does your heart do? It tries to make up for it. It tries to compensate. And just like in left-sided failure, it's gonna try to both beat harder and beat faster. And this come sometimes be felt as palpitations. Palpitations meaning that it feels like your heart's racing or maybe it feels like it's beating a lot harder than it usually does. So overall these symptoms, these forward failure symptoms, are gonna be very similar to left-sided failure. Backward failure symptoms, remember, are symptoms of congestion or fluid buildup. And this fluid buildup in right-sided failure though, unlike in left-sided failure, doesn't happen in the lungs. Where does it happen then? Well let's think about this circulatory system again for a second. Since the deoxygenated blood's coming from the body, but that side isn't pumping it out as well it starts to back up to the body. And just like the classic traffic jam analogy, as less cars are let through, they start to get backed up, right? Well, it's the same thing with the heart, but this time the blood's backing up into the body. Alright, so it builds up in the body. But that's pretty vague though, right? Because I feel like there's a lot of places in the body where it could build up. Well since your feet and your legs are usually the lowest part of your body, right? Gravity tends to cause that fluid to build up in your lower extremities, and it's not uncommon for patients to have this fluid buildup and swelling in their ankles. And another area of potential swelling that's not in your lower extremities is actually in the veins of your neck and most visibly in the jugular vein. So remember that veins carry blood to your heart, and arteries carry blood away from your heart. And the jugular vein carries deoxygenated blood from your head, so this vein is trying to carry this deoxygenated blood from your head to the right side of your heart, but with backward failure it's gonna have some trouble doing that, right? And this fluid can start to build up and cause the pressure in these veins, or the venous pressure, to increase. And this will cause these veins to visibly swell. And more fluid means more fluid weight, right? So it follows that just like left-sided heart failure, some patients might notice that they're gaining weight and this is due to the extra fluid weight. Unlike left-sided failure though, where urine production actually goes down, now urination may actually increase, especially at night when you lie down. So when you're lying down, gravity causes this fluid that's accumulated in your legs, feet, and ankles to move back into the bloodstream where it can be taken up by the kidneys and eliminated as urine. And this will cause more frequent urination at night.