What is an expected finding in a patient with left-sided heart failure and increased pulmonary artery wedge pressure (PAWP)?

In left-sided heart failure, one of the hallmark findings is the accumulation of fluid in the lungs due to increased pressure in the pulmonary circulation, reflected by elevated pulmonary artery wedge pressure (PAWP). This can lead to pulmonary congestion and pulmonary edema.

Shortness of breath, especially when the patient is lying down (orthopnea) or with exertion, is a common symptom associated with this condition. The lungs become filled with excess fluid, making it difficult for oxygen to be exchanged efficiently, which can manifest as dyspnea.

While pink-tinged sputum, or "frothy" sputum, may occur due to the presence of blood in the fluid leaked into the alveoli, it is not the most straightforward or universally present expected finding across all cases of left-sided heart failure. It may occur in more severe cases of pulmonary edema or when there is significant rupture of pulmonary capillaries.

Pitting edema is typically associated with right-sided heart failure or systemic fluid overload rather than left-sided heart failure specifically. Likewise, chest pain may occur but is not a specific finding related to the classic congestion patterns seen with left-sided heart failure.

Therefore, shortness of breath is a more common and expected finding in left-sided heart failure because it directly