In individuals with left heart diseases (LHD), the coexistence of PH and right ventricular dysfunction is a common finding, notably leading to elevated mortality rates. This group encompasses patients suffering from heart failure, irrespective of their ejection fraction status, left-sided valvular heart diseases, as well as congenital or acquired cardiovascular conditions, all leading to post-capillary PH. Optimizing the treatment of the underlying cardiac condition is the primary approach, and it should aim to maintain the function of the right ventricle. Indeed, the deterioration of right ventricular function over time is associated with unfavorable outcomes. In cases of fluid retention resulting from PH-LHD, diuretics continue to be the fundamental component of medical therapy.