Which sign is most characteristic of right-sided heart failure?

Which sign is most characteristic of right-sided heart failure?

• A. Peripheral edema
• B. Pulmonary crackles
• C. Orthopnea
• D. S3 gallop

Answer: (A)

Right-sided heart failure causes congestion of the systemic venous circulation. When the right ventricle can’t pump effectively into the pulmonary circuit, blood backs up in the veins, leading to fluid buildup in dependent areas like the legs and ankles—peripheral edema. This edema is a classic, defining sign of right-sided failure. Pulmonary crackles reflect fluid in the lungs from left-sided heart failure or pulmonary congestion, not the systemic venous congestion of right-sided failure. Orthopnea also stems from pulmonary edema and is more typical of left-sided issues. An S3 gallop signals volume overload and dilated, stiff ventricles in heart failure overall, but it’s not as specifically characteristic of right-sided failure as peripheral edema.

Right-sided heart failure causes congestion of the systemic venous circulation. When the right ventricle can’t pump effectively into the pulmonary circuit, blood backs up in the veins, leading to fluid buildup in dependent areas like the legs and ankles—peripheral edema. This edema is a classic, defining sign of right-sided failure.

Pulmonary crackles reflect fluid in the lungs from left-sided heart failure or pulmonary congestion, not the systemic venous congestion of right-sided failure. Orthopnea also stems from pulmonary edema and is more typical of left-sided issues. An S3 gallop signals volume overload and dilated, stiff ventricles in heart failure overall, but it’s not as specifically characteristic of right-sided failure as peripheral edema.