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Understanding the Mnemonics for Right vs. Left Heart Failure

Andrea Salzman, MS, PT

January 15, 2026

Question

Does the mnemonic for right and left heart failure describe where each ventricle pumps blood, or where blood backs up and causes symptoms, and how does this explain why right heart failure leads to systemic signs like peripheral edema while left heart failure causes pulmonary symptoms?

Answer

 

The mnemonic does not describe where each ventricle normally pumps blood (right ventricle → lungs; left ventricle → periphery). Rather, it explains where blood backs up and where in the body symptoms will appear when each side of the heart fails.

Right Heart Failure

The right ventricle cannot pump blood efficiently to the lungs. This causes blood to back up into the body’s venous system, leading to:

  • Peripheral edema (leg swelling)

  • Ascites (abdominal bloating)

  • Jugular venous distension

Mnemonic:
Right = Rest of the body. Because the heart cannot pump efficiently to the lungs, blood backs up in the venous system. There is too much fluid in the rest of the body, which is why you see swelling in the periphery.

Left Heart Failure

The left ventricle cannot pump blood forward into the systemic circulation efficiently. This causes blood to back up into the lungs, leading to:

  • Pulmonary congestion

  • Dyspnea (shortness of breath)

  • Orthopnea (difficulty breathing when lying down)

  • Fatigue (due to poor systemic circulation)

Mnemonic:
Left = Lungs. Because blood cannot move into the periphery, it backs up into the lungs. There is too much fluid in the lungs, which causes breathing difficulties.

 


andrea salzman

Andrea Salzman, MS, PT

Andrea Salzman, MS, PT is the Founder and CEO of a new non-profit, the Aquatic Therapy Foundation, Inc. (launched in 2026). She has served as the Executive Director of Aquatic Therapy University (ATU), a global continuing education provider, since 2010. Andrea is a licensed physical therapist with over 30 years of experience educating physical, occupational, and speech therapists in evidence-based aquatic therapy across pediatric, adult, neurologic, orthopedic, and cardiopulmonary populations. Andrea has served as Editor-in-Chief of the Journal of Aquatic Therapy for the American Physical Therapy Association (APTA) and has received numerous industry honors, including the APTA's Judy Cirullo Award, recognizing leadership and contributions to aquatic therapy practice. Her life's work emphasizes translating the therapeutic properties of water into clinically defensible, functionally relevant interventions for all who find themselves standing at the water's edge. Aquatic Therapy University's global clearinghouse of information is located online at: www.aquatictherapyuniversity.com. 

 


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