Which sign is commonly observed in patients with right-sided heart failure?

• A. Dependent edema
• B. Jugular venous distention
• C. Pulmonary crackles
• D. Orthopnea

Answer: (A)

Right-sided heart failure leads to backup of blood into the systemic venous system, causing fluid to accumulate in dependent tissues. The legs and feet are especially prone to edema because gravity concentrates the fluid there, making dependent edema the most noticeable and commonly observed sign. Jugular venous distention can also occur due to elevated central venous pressure, but leg swelling is typically more readily observed and describes the classic pattern of systemic congestion. Pulmonary crackles and orthopnea arise from fluid backing up into the lungs, which is a hallmark of left-sided heart failure, not the right-sided pattern. In cases of mixed or predominantly left-sided failure, you might see multiple signs, but dependent edema best reflects the venous congestion seen with right-sided failure.