Heart Failure: What Killed George Carlin?

Medical Author: Benjamin Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Dying of heart failure is not a pleasant way to go, but George Carlin never took the easy route. George Carlin's fans expected nothing but the blunt truth from him on stage; in his honor, here's a little blunt truth about heart failure.

Think of the heart as having two sides with two chambers on each side. The atrium accepts blood and the ventricle pumps it. The right side of the heart receives blood from the body and pumps it to the lungs to get oxygen. The left side of the heart gets this blood back from the lungs and pumps it to the rest of the body.

Picture of the heart, valves, right and left ventricles, right and left atria

Right-sided heart failure means that the right ventricle doesn't have enough strength to pump the blood that arrived from the body toward the lungs. Gravity causes the blood to pool in the lower parts of the body, and fluid leaks from the blood vessels into tissues causing swelling of the legs (and if you sit a lot, into your buttocks).

Left-sided heart failure is similar, except that the left ventricle doesn't have enough strength to pump blood out to the body, causing fluid to back up into the lung tissue, making it hard for oxygen (received from air inhaled) to bind to hemoglobin molecules in the blood. This in turn leads to increasing shortness of breath.