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

• A. Pulmonary edema
• B. Jugular venous distention (JVD)
• C. Cough
• D. Orthopnea

Answer: (D)

Right-ventricular failure causes blood to back up into the systemic venous system, raising pressure in the right atrium and its connected veins. This backflow is most readily observed as jugular venous distention, a hallmark sign of elevated right-sided filling pressures. Left-sided signs like pulmonary edema, orthopnea, and a productive cough stem from backward pressure into the lungs and are less typical of isolated right-sided failure. So, the presence of jugular venous distention reflects the systemic venous congestion that characterizes right-ventricular failure.