What is an sign of right-sided heart failure?

Hepatosplenomegaly is a clinical sign often associated with right-sided heart failure. In right-sided heart failure, the right ventricle is unable to effectively pump blood into the pulmonary circulation, which leads to increased systemic venous pressure. This increased pressure can cause engorgement of the hepatic veins (leading to hepatomegaly) and also cause congestion in the splenic veins (resulting in splenomegaly).

When the right side of the heart fails, the resulting backup of blood affects not just the systemic circulation but also leads to fluid retention, ultimately affecting organs such as the liver and spleen. Therefore, the presence of hepatosplenomegaly serves as an important clinical sign of right-sided heart failure, reflecting the consequences of systemic venous congestion.

Other options, while they may be related to heart failure in a broader sense, are not specific indicators of right-sided heart failure. Rales or rhonchi and pulmonary congestion are more indicative of left-sided heart failure, where the inability to handle blood returning from the lungs causes congestion and respiratory symptoms. Pink frothy sputum is also associated with acute pulmonary edema, primarily seen in left-sided heart failure.