Question 1 of 8

Question

Howard, age 58, presents to the emergency department with a variety of signs and symptoms. Howard has a history of cardiac difficulties, including a myocardial infarction 5 years ago. Since that time, Howard has continued to struggle with lifestyle modifications, such as diet and exercise, to reduce his risk of future cardiac events.

As the first clinician to see Howard, you record the following signs and symptoms:
headache and memory loss; cyanosis; heart rate of 100 bpm; BP of 100/70 mm Hg; ascites; orthopnea; paroxysmal nocturnal dyspnea; pulmonary crackles and edema; peripheral edema; and cool, pale extremities.

Which of his signs and symptoms are associated with right-sided heart failure? Select all that apply.
Ascites
Headache and memory loss
Cyanosis
Peripheral edema
Cool, pale extremities

Answer 1

In the context of heart failure, particularly right-sided heart failure, the following signs and symptoms are associated:

1. Ascites - This refers to fluid accumulation in the abdominal cavity, which is commonly seen in right-sided heart failure due to increased pressure in the venous system.

2. Peripheral Edema - This refers to swelling in the lower extremities due to fluid retention and is another common manifestation of right-sided heart failure.

3. Cyanosis - This is a bluish discoloration of the skin and mucous membranes, which can occur due to inadequate oxygenation (though it is often more associated with left-sided heart failure or severe cases).

4. Cool, Pale Extremities - This can occur due to poor circulation and reduced cardiac output associated with right-sided heart failure.

Headache and memory loss are more associated with other possible conditions, often related to decreased perfusion or neurological issues, and not typically directly linked to right-sided heart failure.

Therefore, the signs and symptoms associated with right-sided heart failure are:

• Ascites
• Peripheral edema
• Cyanosis
• Cool, pale extremities

So the selected options are Ascites, Peripheral edema, Cyanosis, and Cool, pale extremities.