Which of the following is not a symptom of congestive heart failure?

In the context of congestive heart failure (CHF), understanding the symptoms is key to recognizing the condition. Dyspnea on exertion, pedal edema, and orthopnea are all common symptoms associated with CHF due to the heart's reduced ability to pump blood effectively, leading to fluid retention and respiratory difficulties.

Dyspnea on exertion refers to shortness of breath that occurs during physical activity, which is a result of fluid buildup in the lungs. Pedal edema involves swelling in the legs and feet, often seen in patients as excess fluid accumulates in peripheral tissues. Orthopnea is the difficulty breathing that occurs when lying flat and is typically relieved by sitting or standing, again a consequence of fluid dynamics and heart function in CHF.

On the other hand, syncope, or fainting, is not a classic symptom of congestive heart failure. While CHF can lead to reduced blood flow and potentially fainting spells, syncope itself is often attributable to other cardiovascular issues such as arrhythmias or significant drop in blood pressure rather than directly from the congestive heart failure process. Therefore, syncope is considered outside the typical symptomatology of CHF.