Left vs right Congestive heart failure (CHF) is when the heart cannot pump enough blood to meet the bodies needs. CHF can be acute or chronic. It can also be left or right-sided. The heart consists of four chambers. The two upper chambers – the left and right atria receive blood from other parts of the body and pump it into the ventricles – which are the lower chambers of the heart. The right ventricle pumps blood into the lungs, the left ventricle pumps blood into all parts of the body. When there is left-sided heart failure, the heart is not pumping blood into the other parts of the body and is backing up into the lungs. This creates hypoxia and respiratory symptoms which include: Fatigue with activity, increased difficulty breathing with activity, inability to breathe unless sitting upright (orthopnea), difficulty breathing while laying flat, elevated blood pressure, productive cough with pink frothy sputum, and decreased urine out. Acute CHF can cause pulmonary edema with sudden hypoxia, restlessness and confusion. Right sided heart failure is caused when the right ventricle is not pumping enough blood into the lungs and the blood/fluid backs up into other parts of the body causing unexplained weight gain from fluid retention, pitting edema in feet and ankles, ascites (fluid retention in the abdomen), loss of appetite or nausea and difficulty breathing due to an enlarged abdomen.