Edema in the ankles is most suggestive of which type of heart failure?

• A. Right Sided Heart Failure
• B. Left Sided Heart Failure
• C. Pulmonary Edema
• D. Dilated Cardiomyopathy

Answer: (A)

Ankle edema in heart failure reflects systemic venous congestion from the right heart. When the right ventricle fails to pump effectively, blood backs up into the large veins, increasing hydrostatic pressure in peripheral capillaries and causing fluid to leak into dependent areas like the ankles. This pattern is typical of right-sided heart failure, or of right-sided involvement in biventricular failure. In contrast, left-sided failure mainly causes fluid backing up into the lungs, leading to pulmonary edema and symptoms such as shortness of breath, not primarily ankle swelling. Dilated cardiomyopathy is a condition that can lead to heart failure but does not by itself explain ankle edema; the edema pattern points toward right-sided venous congestion. Therefore, the ankle edema is most suggestive of right-sided heart failure.