Which of the following is a sign of left-sided heart failure?

• A. Peripheral edema
• B. JVD
• C. Ascites
• D. Pulmonary edema

Answer: (D)

Left-sided heart failure causes blood to back up into the lungs, raising the hydrostatic pressure in pulmonary capillaries. Fluid then leaks into the lung interstitium and alveoli, leading to pulmonary edema with symptoms like shortness of breath, crackles on auscultation, and orthopnea. This pulmonary congestion is the hallmark sign of left-sided failure.

The other signs listed—peripheral edema, jugular venous distension, and ascites—reflect congestion of the systemic venous circulation and are more typical of right-sided heart failure (though both sides can fail together in biventricular failure). Hence, pulmonary edema is the correct sign associated with left-sided heart failure.