Which of the following is a clinical feature of right-sided heart failure?

The correct choice highlights decreased appetite and nausea as a clinical feature of right-sided heart failure. This symptom is primarily due to the congestion of blood in the systemic circulation, which can affect the liver and gastrointestinal tract. In right-sided heart failure, the heart’s ability to pump effectively leads to increased pressure in the venous system. This congestion can impair venous return from the abdominal organs, leading to symptoms such as decreased appetite, nausea, and abdominal discomfort.

The other symptoms listed are typically more associated with left-sided heart failure or can arise due to heart failure in general but are not specific to the right-side dysfunction. For instance, orthopnea is a symptom where patients experience difficulty breathing when lying flat, which is more commonly seen in left-sided heart failure due to pulmonary congestion. Syncope, or fainting, may occur in a variety of cardiac conditions but is not a hallmark of right-sided heart failure. Chest pain can indeed occur in various cardiac conditions including ischemia, but it is not a distinctive feature of right-sided heart failure specifically, which more typically presents with peripheral symptoms due to fluid overload.

Thus, decreased appetite and nausea is a direct reflection of the physiological consequences of right-sided heart failure, making it the appropriate choice.