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

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

• A. Jugular venous distension
• B. Basilar crackles
• C. Orthopnea
• D. Nocturnal cough

Answer: (A)

Jugular venous distension signals elevated pressure in the central venous system, which happens when the right ventricle struggles to pump blood forward. That back-up leads to venous congestion throughout the body, especially in the neck veins you can observe as a distended jugular venous pulse. In right-sided heart failure, this systemic venous congestion is a hallmark finding, making jugular venous distension the best clue. The other signs point more to fluid backing up into the lungs from left-sided failure—basilar crackles come from pulmonary edema, orthopnea is trouble breathing when lying flat due to lung congestion, and nocturnal cough often reflects nocturnal pulmonary congestion.

Jugular venous distension signals elevated pressure in the central venous system, which happens when the right ventricle struggles to pump blood forward. That back-up leads to venous congestion throughout the body, especially in the neck veins you can observe as a distended jugular venous pulse. In right-sided heart failure, this systemic venous congestion is a hallmark finding, making jugular venous distension the best clue. The other signs point more to fluid backing up into the lungs from left-sided failure—basilar crackles come from pulmonary edema, orthopnea is trouble breathing when lying flat due to lung congestion, and nocturnal cough often reflects nocturnal pulmonary congestion.