Left- versus right-sided heart failure

Heart failure presents on whichever side of the circulation is backing up, so left ventricular failure congests the lungs and shows itself as breathlessness on exertion and on lying flat, nocturnal breathlessness and cough, crackles, frothy or blood-tinged sputum, fatigue and hypoxemia, while right ventricular failure congests the systemic veins and shows itself as distended neck veins, dependent then generalized edema, an enlarged tender liver, abdominal fullness, nausea and a climbing daily weight — and because failure of the left side is the commonest reason the right side follows, the patient is assessed for both pictures rather than sorted into one.