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Medicine General 02c24d52

All the following are features of right sided hea failure, Except:

A
Increased PCWP
B
Pulsatile liver
C
Increased JVP
D
Positive hepatojugular reflex
High-Yield Explanation
Answer is A (Increased PCWP) Elevated Pulmonary capillary wedge pressure (1 PCWP) is a feature of left sided hea failure and not right sided hea failure. Failure of Right ventricle results in systemic congestion, and not pulmonary congestion and hence PCWP is not raised unless Right hea, failure is caused:secondary to Left sided failure. Left hea failure Left hea failure is defined as a clinical syndrome where the dominant feature is fluid congestion in the lungs (pulmonary) rather than in the systemic circulation The pulmonary capillary wedge pressure is typically elevated (1-PCWP) Predominant symptoms are related to passive congestion of lungs and pulmonary edema Dyspnea Ohopnea Paroxysmal Nocturnal Dyspnea (PND) Cough with Pink Frothy Sputum Rales / Crackles Right hea failure Right hea failure is defined as a clinical syndrome where the dominant feature is fluid congestion in the systemic circulation. The pulmonary capillary wedge pressure is normal (Normal PCWP) unless Right hea failure is caused secondary to left sided hea failure (Ted PCWP) (PCWP is not elevated in isolated Right hea failure) Predominant symptoms are related to passive systemic congestion Peripheral Edema Ascitis Congestive hepatomegaly (may be pulsatile) Congestive splenomegaly Weight gain Nocturia Raised JVP Positive Hepatojugular reflex

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