Which sign most strongly indicates right-sided heart failure?

Which sign most strongly indicates right-sided heart failure?

• A. Hepatic engorgement with ascites
• B. Jugular venous distention
• C. Orthopnea
• D. Pulmonary edema

Answer: (B)

Right-sided heart failure raises pressure in the systemic venous system, so the most telling sign is jugular venous distention. When the right atrium can’t receive blood effectively, venous pressure backs up into the neck veins, making them visibly distended, especially when the patient is at a modest incline. This sign directly reflects elevated central venous pressure and is a strong clue that the failure is affecting the right side. Orthopnea and pulmonary edema come from left-sided failure, where fluid backs into the lungs rather than the systemic veins. Hepatic engorgement with ascites can occur with right-sided failure too, but it's less immediate and specific than a prominent jugular venous pulse. So, jugular venous distention is the best indicator of right-sided heart failure.

Right-sided heart failure raises pressure in the systemic venous system, so the most telling sign is jugular venous distention. When the right atrium can’t receive blood effectively, venous pressure backs up into the neck veins, making them visibly distended, especially when the patient is at a modest incline. This sign directly reflects elevated central venous pressure and is a strong clue that the failure is affecting the right side.

Orthopnea and pulmonary edema come from left-sided failure, where fluid backs into the lungs rather than the systemic veins. Hepatic engorgement with ascites can occur with right-sided failure too, but it's less immediate and specific than a prominent jugular venous pulse. So, jugular venous distention is the best indicator of right-sided heart failure.