Types of cardiac insufficiency (right ventricle)

1. Acute insufficiency of the right ventricle

Acute insufficiency of the right ventricle is much less common than that of the left. This insufficiency usually emerges as a consequence of a pulmonary embolisms, or as a result of a great physical exertion in patients with compensated mitral stenosis, etc.

Symptoms include:

  • Cyanosis
  • Swelling of the jugular veins
  • Enlargement of the liver (this is also accompanied by pain in this region)
  • Collapsed state with prominent tachycardia
  • Anuria (lack of urination)

2. Chronic insufficiency of the right ventricle

  • Pain in the right hypochondrium. In this type of insufficiency patients complain of a feeling of heaviness or pain in the right hypochondrium ( the abdomen should be divided into 4 parts from top to bottom, from the left to the right, in this case the pain would be localized to the upper right quadrant), which is due to the enlargement of the liver from the stasis and strain on the Glisson’s capsule.
  • The liver is enlarged, the surface turned flat while the corners are rounded, its consistency denser and painful upon palpation. While palpating (pressing on the liver) one can observe a swelling of the jugular veins, this is termed the hepatojugular reflux.
  • Heaviness in the right hypochondrium
  • Cyanosis of the lips and cheekbones
  • Cyanosis of the nailbeds
  • Oliguria during the day and nicturia during the night
  • Gastrointestinal issues
  • Tachycardia
  • Edema. Edema occurs in the lower extremities, they are soft because if pressed, the finger leaves a mark, without causing any pain. In more advanced stages there is transudate in the serous cavities such as ascites (accumulation of water in the belly), hydrothorax (accumulation of water in the thoracic region), in more rare cases, hydro pericarditis.  When the entire body swells, hence when the edemas become generalized, this is called anasarca.

Medically Reviewed by a doctor on 19 Jun 2018
Medical Author: Dr. med. Diana Hysi