The most common cause of right heart failure is left heart failure. However, failure of the right side of the heart can occur as a pure phenomenon in cor pulmonale, i.e. right ventricular strain produced by intrinsic disease of the lungs or pulmonary vasculature.
In these cases, the right ventricle is burdened by increased resistance within the pulmonary circulation. Dilatation of the heart is confined to the right ventricle and atrium.
Other less common causes of right-sided heart failure include the various forms of cardiomyopathy and diffuse myocarditis, which appear to affect the right ventricle more often than the left.
Rarely, right-sided heart failure is caused by tricuspid or pulmonary valvular lesions, or as a complication of the carcinoid syndrome.
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