Which symptom is associated with left-sided heart failure?

Orthopnea is a symptom specifically associated with left-sided heart failure, characterized by difficulty breathing while lying flat. This is due to the accumulation of fluid in the lungs, known as pulmonary congestion, which occurs when the left side of the heart is unable to effectively pump blood out to the body. When lying down, the redistribution of body fluids increases venous return to the heart, further exacerbating pulmonary congestion and making breathing more difficult. Patients often find relief by sitting up, which helps to alleviate dyspnea.

In contrast, the other symptoms listed relate more to right-sided heart failure or other conditions. For example, distention of neck veins typically indicates fluid overload and is more commonly associated with right-sided heart failure. Recurrent abdominal pain and nonhealing leg ulcers can indicate various circulatory issues and systemic conditions but are not exclusive symptoms of left-sided heart failure. Therefore, orthopnea stands out as a key symptom directly tied to the mechanical and hemodynamic changes occurring with left-sided heart failure.