In a patient with hypothyroidism, which clinical manifestation would be indicative of right-sided heart failure?

Leg edema


• The fact that the patient has hypothyroidism is a "red-herring"- that is, an extra detail that is unnecessary and has no bearing on a question about left vs right-sided heart failure. Do not let details like these throw you off.

• Signs and symptoms of right-sided heart failure include peripheral edema, ascites, jugular vein distention, and hepatomegaly.

• These symptoms are caused by a diminished ability of the right ventricle to pump blood, allowing it to back up into the vena cava. This causes blood to pool in the extremities, abdomen, neck, and liver.

• Incorrect: Left-sided symptoms are caused by a diminished ability of the left ventricle to pump blood into the aorta and systemic circulation. This leads to backup in the pulmonary circulation, causing pulmonary edema. Dry cough, crackles, and cyanosis are signs of left-sided heart failure.

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