A client asks what could have caused right-sided heart failure. Which explanation is best?

• A. High blood pressure in the lungs.
• B. Long term hypertension.
• C. The inability of the mitral valve to close properly.
• D. Narrowing of the aorta.

Answer: (A)

Right-sided heart failure occurs when the right ventricle can’t cope with the high resistance in the pulmonary circulation. When the pressures in the lungs are elevated (pulmonary hypertension), the right ventricle faces a heavy afterload. Over time it can hypertrophy, dilate, and fail to pump effectively, causing blood to back up in the systemic veins. This leads to signs like leg edema, hepatomegaly, ascites, and jugular venous distension.

Long-term systemic hypertension mainly stresses the left ventricle, not the right. Mitral valve closure issues cause left-sided congestion from backward flow into the lungs, and aorta narrowing places extra load on the left ventricle as well. These scenarios don’t primarily explain right-sided failure.