Rosh Emergency Medicine Practice Test

What vital sign change would you expect in a patient experiencing heart failure?

1. Blood pressure of 160/90 mmHg

2. Heart rate of 50 bpm

3. Temperature of 100.4°F

4. Respiratory rate of 24 breaths/min

The correct answer is: Respiratory rate of 24 breaths/min

In heart failure, it is common to observe an increased respiratory rate, which can be attributed to several factors. As the heart struggles to pump blood effectively, fluid can accumulate in the lungs, leading to pulmonary congestion. This condition decreases the efficiency of gas exchange and can result in hypoxia. In response to these changes, the body attempts to compensate by increasing the respiratory rate to improve oxygen intake and remove carbon dioxide. Thus, a respiratory rate of 24 breaths per minute indicates a compensatory mechanism in the face of respiratory distress often seen in heart failure. In contrast, a blood pressure of 160/90 mmHg typically suggests hypertension rather than heart failure. A heart rate of 50 beats per minute may indicate bradycardia, which is not characteristic of heart failure; patients often present with a tachycardic response as the body compensates for decreased cardiac output. A temperature of 100.4°F may reflect a mild fever, which is not a direct indicator of heart failure but could suggest an infectious process that should be evaluated independently.