Which symptom is commonly seen in acute decompensated heart failure?

Which symptom is commonly seen in acute decompensated heart failure?

• A. Thick, white sputum
• B. Wheezing
• C. Orthopnea
• D. Crackles that clear with coughing

Answer: (C)

When heart failure worsens, breathing trouble is strongly tied to body position. Lying flat increases venous return to the heart, which raises pulmonary capillary pressure and pushes fluid into the lungs, making it hard to breathe. This positional shortness of breath is known as orthopnea, and patients often feel relief when they sit up or sleep propped up on pillows.

That makes orthopnea the best choice because it directly reflects the fluid overload and pulmonary congestion seen in acute decompensated heart failure. The other signs can appear in various conditions: thick white sputum points more toward infection or bronchitis, wheezing isn’t specific and can occur with several respiratory issues, and crackles are common with edema but don’t capture the positional breathlessness that orthopnea uniquely characterizes.