Symptoms of right sided heart failure | Circulatory System and Disease | NCLEX-RN | Khan Academy
Aug 26, 2023
Symptoms of right sided heart failure | Circulatory System and Disease | NCLEX-RN | Khan Academy
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2.758 -> - [Voiceover] So we know that the symptoms
3.733 -> of heart failure can be a little different
5.176 -> depending on which side of
the heart we're talking about.
7.267 -> If we're gonna talk about the right side,
8.995 -> we're talking about the side
that deals with the blood
10.702 -> that's just been used by the body,
12.774 -> and so it has less oxygen or
we call it deoxygenated blood.
16.391 -> So this blood comes into the right side
18.299 -> and then it's pumped to the lungs
19.6 -> where it can get more oxygen there,
21.184 -> and it can get reoxygenated.
23.42 -> And if we have right-sided heart failure,
25.31 -> this means that the heart
doesn't pump as much blood
27.382 -> as it should to the lungs.
29.333 -> And so the symptoms that result
30.571 -> are going to be a little
different for this type
31.953 -> than when we talk about left-sided failure
34.249 -> where it pumps it to the body.
36.656 -> What is similar though,
is that we can talk
38.385 -> about both forward and
backward failure symptoms.
42.021 -> And let's just remember
that forward failure means
43.077 -> that these symptoms revolve
around the right side's ability
46.085 -> to pump blood out of
the heart to the lungs.
49.997 -> And when we say backward
failure we're talking about
51.683 -> the symptoms that result
from this backup of blood
54.081 -> that's trying to get into the heart.
56.072 -> And this time it's in the right side,
57.271 -> so it's coming from the body.
60.148 -> So starting with forward failure,
61.855 -> just like in the left
side weakness and fatigue
63.663 -> is gonna be a major symptom.
65.634 -> But it comes about slightly differently.
67.807 -> So the right side's
responsible for pumping blood
69.575 -> to the lungs that's been
used up by the body.
72.073 -> So in other words there's less oxygen
73.923 -> and more carbon dioxide.
76.157 -> Usually you'd want this
blood pumped to your lungs
77.864 -> to have that carbon dioxide
exchanged for oxygen,
80.831 -> so it's like your trading the
carbon dioxide for oxygen.
83.716 -> But when it's not pumping as much blood,
85.808 -> that means there isn't
as much of this exchange
88.003 -> of carbon dioxide for oxygen,
and so the body receives
91.213 -> less oxygen and this is
felt, just as before,
94.26 -> as tiredness, weakness,
and fatigue since your body
96.698 -> needs oxygen and it doesn't
need carbon dioxide.
101.11 -> And when your body doesn't
receive as much oxygen,
102.96 -> what does your heart do?
103.935 -> It tries to make up for it.
105.114 -> It tries to compensate.
106.455 -> And just like in left-sided failure,
108.527 -> it's gonna try to both beat
harder and beat faster.
111.676 -> And this come sometimes
be felt as palpitations.
114.642 -> Palpitations meaning that it feels like
116.632 -> your heart's racing or maybe it feels like
118.584 -> it's beating a lot harder
than it usually does.
122.257 -> So overall these symptoms,
these forward failure symptoms,
125.085 -> are gonna be very similar
to left-sided failure.
130.502 -> Backward failure symptoms,
remember, are symptoms
132.613 -> of congestion or fluid buildup.
134.604 -> And this fluid buildup in
right-sided failure though,
136.839 -> unlike in left-sided failure,
doesn't happen in the lungs.
140.557 -> Where does it happen then?
141.898 -> Well let's think about this
circulatory system again
143.909 -> for a second.
145.189 -> Since the deoxygenated
blood's coming from the body,
148.724 -> but that side isn't pumping it out as well
151.244 -> it starts to back up to the body.
154.78 -> And just like the classic
traffic jam analogy,
157.279 -> as less cars are let through,
158.925 -> they start to get backed up, right?
160.977 -> Well, it's the same thing with the heart,
161.972 -> but this time the blood's
backing up into the body.
166.381 -> Alright, so it builds up in the body.
168.168 -> But that's pretty vague though, right?
169.713 -> Because I feel like
there's a lot of places
171.236 -> in the body where it could build up.
173.227 -> Well since your feet and your legs
174.568 -> are usually the lowest
part of your body, right?
176.864 -> Gravity tends to cause
that fluid to build up
179.363 -> in your lower extremities,
and it's not uncommon
181.761 -> for patients to have this fluid buildup
183.67 -> and swelling in their ankles.
188.374 -> And another area of potential swelling
190.223 -> that's not in your lower extremities
192.052 -> is actually in the veins of your neck
193.799 -> and most visibly in the jugular vein.
196.948 -> So remember that veins
carry blood to your heart,
199.122 -> and arteries carry blood
away from your heart.
201.58 -> And the jugular vein
carries deoxygenated blood
203.917 -> from your head, so this
vein is trying to carry
206.152 -> this deoxygenated blood from your head
208.102 -> to the right side of your heart,
209.91 -> but with backward failure it's gonna have
211.394 -> some trouble doing that, right?
213.242 -> And this fluid can start to build up
214.746 -> and cause the pressure in these veins,
216.656 -> or the venous pressure, to increase.
219.236 -> And this will cause these
veins to visibly swell.
224.692 -> And more fluid means
more fluid weight, right?
227.211 -> So it follows that just like
left-sided heart failure,
229.527 -> some patients might notice
that they're gaining weight
232.087 -> and this is due to the extra fluid weight.
235.51 -> Unlike left-sided failure
though, where urine production
238.009 -> actually goes down, now
urination may actually increase,
241.606 -> especially at night when you lie down.
244.176 -> So when you're lying down,
gravity causes this fluid
246.675 -> that's accumulated in your
legs, feet, and ankles
249.357 -> to move back into the bloodstream
251.246 -> where it can be taken up by the kidneys
252.851 -> and eliminated as urine.
254.497 -> And this will cause more
frequent urination at night.
Source: https://www.youtube.com/watch?v=pLba3OzsfDU
