Which of the following is NOT a cardinal symptom of congestive heart failure?

• A. Dyspnea on exertion
• B. Orthopnea
• C. Edema
• D. Fever

Answer: (D)

The main idea is recognizing which signs truly reflect congestive heart failure. In CHF, the heart’s reduced pumping leads to fluid backup and trouble meeting body demands, so certain symptoms repeatedly appear.

Dyspnea on exertion shows up because the lungs become congested as pressures back up when the heart can’t keep up with demand, so even light activity provokes shortness of breath. Orthopnea happens when lying flat increases venous return and worsens pulmonary congestion, often forcing patients to sleep propped up or upright. Edema results from higher venous pressures and salt and water retention, leading to swelling in the legs, abdomen, or elsewhere.

Fever, on the other hand, is not a typical or cardinal sign of heart failure. It points more to infection or inflammation (such as pneumonia or endocarditis) and would prompt evaluation for non-cardiac causes rather than being a direct feature of heart failure itself.