Discharge teaching about left-sided systolic dysfunction: which statement is NOT correct?

• A. Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough, difficulty breathing while lying down, and weight gain.
• B. It is important to monitor your daily weights, fluid and salt intake.
• C. Left-sided heart failure can lead to right-sided heart failure, if left untreated.
• D. This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema.

Answer: (D)

The situation tests understanding of where congestion occurs in heart failure and how discharge teaching fits with left-sided systolic dysfunction. In left-sided heart failure, the backup of blood is primarily into the lungs, causing pulmonary symptoms such as dyspnea, orthopnea, a persistent cough, and weight gain from fluid retention. Teaching patients to monitor daily weights and limit fluid and salt intake directly addresses this fluid status and helps prevent pulmonary congestion from worsening.

Left-sided failure can progress to right-sided failure if it’s not treated, because the increased pressures from the lungs transmit back to the right heart over time, leading to systemic venous congestion. This progression underscores the link between the two sides of the heart, but it’s important to note that hepatic congestion and the resultant peripheral edema are hallmark features of right-sided (or bi-ventricular) failure, not the primary consequence of isolated left-sided systolic dysfunction.

So the statement about pressure building in the hepatic veins and causing them to congest with fluid leading to peripheral edema describes right-sided pathology rather than left-sided systolic failure, making it the not-correct option for this question.