Which condition presents with wheezes, dependent edema, and pink frothy sputum?

• A. Congestive heart failure / pulmonary edema
• B. Asthma
• C. COPD
• D. Pneumonia

Answer: (A)

Wheezes with dependent edema and pink frothy sputum point to acute pulmonary edema from congestive heart failure. When the left side of the heart fails, pressure backs up into the pulmonary circulation, causing fluid to leak into the interstitium and alveoli. This pulmonary fluid overload narrows airways, producing wheezes, and the edema plus capillary leak can trigger a reflex bronchospasm as well. The pink, frothy sputum arises from fluid mixed with blood in the alveoli. The dependent edema reflects overall venous congestion from heart failure. Other conditions don’t fit all three signs as neatly: asthma mainly causes wheeze from bronchospasm without the fluid overload and pink frothy sputum; COPD can have wheeze but edema and pink frothy sputum are not defining features; pneumonia presents with infection signs and a different sputum character rather than pink frothy fluid.