Which symptom is classic for left-sided heart failure and often worsens at night?

Which symptom is classic for left-sided heart failure and often worsens at night?

• A. Nocturnal paroxysmal dyspnea
• B. Bilateral leg edema
• C. Abdominal swelling
• D. Hepatomegaly

Answer: (A)

When the left ventricle fails, blood backs up into the lungs, causing pulmonary congestion. Lying flat at night increases venous return to the heart, raising pulmonary capillary pressure and edema, which often triggers sudden, severe shortness of breath that wakes you from sleep. This pattern is classic for left-sided heart failure and is specifically described as nocturnal paroxysmal dyspnea. The other signs—leg edema, abdominal swelling, and hepatomegaly—reflect systemic venous congestion and are more typical of right-sided (or combined) heart failure, not the characteristic nighttime pulmonary symptoms of left-sided failure.

When the left ventricle fails, blood backs up into the lungs, causing pulmonary congestion. Lying flat at night increases venous return to the heart, raising pulmonary capillary pressure and edema, which often triggers sudden, severe shortness of breath that wakes you from sleep. This pattern is classic for left-sided heart failure and is specifically described as nocturnal paroxysmal dyspnea. The other signs—leg edema, abdominal swelling, and hepatomegaly—reflect systemic venous congestion and are more typical of right-sided (or combined) heart failure, not the characteristic nighttime pulmonary symptoms of left-sided failure.