Differentiate left-sided and right-sided heart failure by typical signs and symptoms.

• A. Left: edema and JVD; Right: dyspnea and crackles.
• B. Left: dyspnea, crackles, orthopnea, basilar edema; Right: peripheral edema, jugular venous distention, hepatomegaly, ascites.
• C. Left: JVD; Right: orthopnea and crackles.
• D. Left: ascites; Right: basilar edema.

Answer: (B)

The question tests how left-sided and right-sided heart failure manifest differently because the fluid backs up in different parts of the body. Left-sided failure causes pulmonary congestion, so you see symptoms related to the lungs: dyspnea, orthopnea (shortness of breath when lying flat), paroxysmal nocturnal dyspnea, and crackles or basilar edema on exam. Right-sided failure causes systemic venous congestion, leading to peripheral edema (often in the legs), jugular venous distention, hepatomegaly, and ascites.

The best option matches this pattern: left-sided signs are dyspnea, crackles, orthopnea, and basilar edema; right-sided signs are peripheral edema, JVD, hepatomegaly, and ascites. The other choices mix signs that belong to the opposite side (for example, edema and JVD are right-sided, while orthopnea and crackles are left-sided), which makes them less consistent with typical presentations.