Which complication may occur with congestive heart failure?

• A. Ascites
• B. Hypoglycemia
• C. Rash
• D. Stroke

Answer: (A)

Fluid overload from congestive heart failure causes venous congestion. When the right side of the heart fails, blood backs up in the systemic veins, including the hepatic circulation. This raises hydrostatic pressure in the liver and other abdominal vessels, pushing fluid out of the capillaries into the peritoneal cavity to form ascites. This buildup of fluid in the abdomen is a classic complication of advanced heart failure, reflecting the systemic congestion that accompanies the condition.

Hypoglycemia and rash don’t arise from the congestive process itself, and while stroke can occur in people with heart disease, it’s not a direct, defining complication of congestive heart failure like ascites is. In some patients with heart failure, especially with atrial fibrillation or vascular disease, stroke risk is elevated, but ascites remains the most characteristic complication due to venous congestion.