Which symptom is primarily associated with left-sided CHF?

The symptom primarily associated with left-sided congestive heart failure (CHF) is dyspnea on exertion. This occurs due to the accumulation of fluid in the lungs, which increases pulmonary pressure and leads to shortness of breath when the body demands more oxygen, especially during physical activity. As the heart's ability to pump blood efficiently diminishes, blood backs up into the pulmonary circulation, causing pulmonary congestion and resulting in difficulty breathing.

While other symptoms may be present in CHF, they are more characteristic of right-sided failure or other cardiac conditions. For instance, edema in the lower extremities is more commonly associated with right-sided heart failure, as it involves fluid accumulation in the body's tissues. Chest pain can result from various cardiac issues but is not specific to left-sided heart failure, and palpitations can occur for a range of reasons unrelated to the left heart function alone. Therefore, dyspnea on exertion is the symptom most directly linked to the dysfunction of the left ventricle in CHF.