What is a common symptom of left-sided heart failure?

• A. Chest pain
• B. Peripheral edema
• C. Hypertension
• D. Dyspnea

Answer: (D)

Left-sided heart failure causes blood to back up into the lungs, raising pulmonary capillary pressure and leading to pulmonary edema. This makes it hard to breathe, especially with activity, so shortness of breath becomes the most common and characteristic symptom. In severe or recumbent states, it can present as orthopnea (dyspnea when lying flat) and paroxysmal nocturnal dyspnea.

Chest pain would point more toward ischemia or coronary problems, while peripheral edema is typically more prominent with right-sided failure or advanced congestive states. Hypertension is a risk factor and can accompany heart failure, but it’s not a symptom the patient experiences in the same way dyspnea is. So the hallmark symptom reflecting the pulmonary congestion from left-sided failure is dyspnea.