On physical exam, which finding indicates left-sided heart failure?

On physical exam, which finding indicates left-sided heart failure?

• A. Rales at the lungs bilaterally
• B. Ascites
• C. Peripheral edema
• D. Elevated JVD

Answer: (A)

Left-sided heart failure raises pressure in the pulmonary circulation, causing fluid to leak into the interstitium and alveoli. This pulmonary edema produces crackles or rales heard on lung examination, often bilaterally at the bases. In contrast, signs like ascites, peripheral edema, and elevated JVD reflect systemic venous congestion from right-sided failure, not the direct pulmonary involvement of left-sided failure. So, rales in both lungs are the classic bedside finding indicating left-sided heart failure.

Left-sided heart failure raises pressure in the pulmonary circulation, causing fluid to leak into the interstitium and alveoli. This pulmonary edema produces crackles or rales heard on lung examination, often bilaterally at the bases. In contrast, signs like ascites, peripheral edema, and elevated JVD reflect systemic venous congestion from right-sided failure, not the direct pulmonary involvement of left-sided failure. So, rales in both lungs are the classic bedside finding indicating left-sided heart failure.