Most patients believe that the heart is one organ and all parts function in the same way. The truth is that the right side of the heart and the left side of the heart have only one common function and that is to contract and pump blood forward. However, the right and left sides function in different pressure environments and even have a different type of muscle structure. The reason these facts are important in a pulmonary article is that the right side of the heart is more closely associated with lung function and lung disease than the left. The function of the lungs can seriously affect the right heart function and damage to the right heart can seriously determine how well patients respond to therapy and how long they will live.

Two common diseases that affect the right heart function are COPD and pulmonary hypertension. Patients with COPD, and especially those that need oxygen therapy, have increased pressures in the pulmonary blood vessels and in the heart itself. The same is true of pulmonary hypertension regardless of cause. The stress these pressures put on the muscle of the right heart can lead to right heart failure. More understanding of the function and dysfunction of the right heart and how it affects patients with COPD is needed. Some of the tools we now have are limited or cumbersome. I have always felt that right heart dysfunction was a signifi cant contributor to the limitations many of our COPD patients experience.