Which of the following is a symptom of right-ventricular failure?

• A. Paroxysmal nocturnal dyspnea
• B. Jugular venous distention
• C. Pulmonary edema
• D. Orthopnea

Answer: (B)

Right-ventricular failure causes systemic venous congestion because the right heart can’t effectively propel blood into the pulmonary circulation. This backs up pressure into the venous system, making jugular veins visibly distended—the classic bedside sign of elevated central venous pressure from RV failure. You’ll often also see hepatic congestion, ascites, and peripheral edema, but the jugular venous distention is the most recognizable clue.

Paroxysmal nocturnal dyspnea and orthopnea occur mainly when left-sided pressures rise and fluid shifts into the lungs, leading to pulmonary congestion. Pulmonary edema itself is fluid overload in the lungs from left-sided failure (or severe combined involvement). So these signs point more toward left-sided or biventricular issues, whereas jugular venous distention specifically highlights right-sided congestion.