Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
A. Angina pectoris
B. Cardiomyopathy
C. Left-sided heart failure
D. Right-sided heart failure
Correct Answer: D. Right-sided heart failure
Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure. When the right side loses pumping power, blood backs up in the body’s veins. This usually causes swelling or congestion in the legs, ankles and swelling within the abdomen such as the GI tract and liver (causing ascites).
Option A: Angina pectoris doesn’t cause weight gain, nausea, or a decrease in urine output. Patients with ACS most commonly present with angina, which patients usually describe as pain, pressure, tightness, or heaviness in the chest, with potential radiation to the jaw or left arm. It may be accompanied by shortness of breath, diaphoresis, nausea, or any combination of the above.
Option B: Cardiomyopathy is usually identified as a symptom of left-sided heart failure. Other signs and symptoms may include dizziness; light-headedness; fainting during physical activity; arrhythmias (irregular heartbeats); chest pain, especially after physical exertion or heavy meals; and heart murmurs. (Heart murmurs are extra or unusual sounds heard during a heartbeat.)
Option C: Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones. Patients with left heart failure may present with complaints of shortness of breath (often on exertion, a sensitivity of 89%), orthopnea (specificity of 89%), paroxysmal nocturnal dyspnea, and/or symptoms of volume overload (e.g., leg swelling, weight gain, increased abdominal girth, or right upper quadrant pain due to liver congestion). Interestingly, some patients with advanced disease might experience weight loss, referred to as “cardiac cachexia.”
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