Which symptom is least likely to occur in patients with right ventricular heart failure?

In right ventricular heart failure, the symptoms are primarily related to the systemic venous congestion due to the impaired ability of the right ventricle to pump blood effectively. Symptoms such as fatigue, dependent edema, and anorexia are commonly observed due to this congestion and the subsequent volume overload.

Crackles, on the other hand, are typically associated with left-sided heart failure, where pulmonary congestion occurs due to increased pressures in the pulmonary circulation. They are indicative of fluid accumulation in the lungs, which is a direct consequence of left heart dysfunction. While right heart failure can eventually lead to left heart failure or contribute to pulmonary congestion, the presence of crackles is not a primary symptom expected in isolated right ventricular failure. Therefore, this makes crackles the least likely symptom to be present in patients experiencing right ventricular heart failure.

Understanding the specific manifestations of right versus left heart failure can assist in recognizing the underlying pathology and tailoring management accordingly.