Which symptom is indicative of right-sided congestive heart failure?

Swelling in the ankles and abdomen is indicative of right-sided congestive heart failure because this condition primarily leads to fluid accumulation in the body's tissues and organs. Right-sided heart failure occurs when the right ventricle is unable to effectively pump blood to the lungs for oxygenation. As a result, blood can back up in the systemic circulation, leading to an increase in venous pressure. This increased pressure forces fluid out of the blood vessels and into surrounding tissues, which predominantly manifests as edema, especially in the lower extremities (ankles) and the abdominal area (ascites).

The other symptoms listed are typically associated with left-sided heart failure. For instance, fluid backing up into the lungs, shortness of breath during exertion, and gasping for air when lying down are manifestations of pulmonary congestion resulting from left-sided heart failure. In contrast, edema in the ankles and abdomen is a hallmark of the right side of the heart's inability to efficiently manage systemic blood flow, highlighting the distinct pathophysiological processes involved in heart failure.