Advanced Patient Assessment Practice Exam

Which of the following findings is most characteristic of left-sided heart failure?

1. Jugular venous distention

2. Pitting edema

3. Orthopnea

4. Ascites

The correct answer is: Orthopnea

Left-sided heart failure is primarily characterized by the inability of the left ventricle to effectively pump blood out to the body. This condition often leads to a backlog of blood in the pulmonary circulation, resulting in various respiratory symptoms and manifestations. Orthopnea, or difficulty breathing while lying flat, is a classic symptom of left-sided heart failure, as patients often find relief when sitting or standing up. This occurs due to increased venous return from the lower extremities when in an upright position, which reduces pulmonary congestion and alleviates the sensation of breathlessness. In contrast, jugular venous distention and ascites are more characteristic of right-sided heart failure, where fluid backs up into the systemic circulation, causing these specific signs. Pitting edema is also associated primarily with right-sided heart failure and reflects fluid accumulation in the extremities. Understanding these mechanisms is crucial, as it helps to differentiate between the right-sided and left-sided heart failure, enabling appropriate management strategies for patients.