North Carolina EMT State Practice Exam

What typically results from left-sided heart failure?

1. Increased peripheral edema

2. Respiratory distress with rales or crackles

3. Jugular venous distension

4. Ascites and abdominal swelling

The correct answer is: Respiratory distress with rales or crackles

Left-sided heart failure primarily affects the heart's ability to pump blood effectively to the rest of the body, leading to a backup of blood in the pulmonary circulation. This congestion can prevent proper oxygenation of the blood, resulting in respiratory issues. Patients often present with signs of respiratory distress, such as difficulty breathing, due to fluid accumulation in the lungs, which manifests as rales or crackles heard upon auscultation. This fluid buildup occurs because the left ventricle is unable to efficiently move blood forward into the systemic circulation, causing pressure to increase in the pulmonary vessels. In contrast, the other options reflect complications that are more closely associated with right-sided heart failure or systemic conditions. For instance, increased peripheral edema and jugular venous distension typically occur with right-sided heart failure due to systemic venous congestion. Ascites and abdominal swelling can also emerge from right-sided heart failure, as fluid accumulates in the abdominal cavity due to increased pressure in the systemic venous system. Thus, the most direct consequence of left-sided heart failure is the respiratory distress characterized by rales or crackles.