Which skin alteration might be observed in a patient with heart failure?

In patients with heart failure, cold and clammy skin can often be observed, particularly during episodes of acute decompensation or when the body is in a state of reduced perfusion. This occurs due to the compensatory mechanisms activated in response to decreased cardiac output. The body may redirect blood flow away from the extremities and skin to prioritize vital organs such as the heart and brain. As a result, skin may become cold to the touch and feel clammy due to limited circulating blood volume and increased sweating from sympathetic nervous system activation.

The presence of cold and clammy skin reflects the body's attempt to maintain hemodynamic stability and can signal a more critical state of heart failure, indicating possible worsening of the patient's condition. This skin change often accompanies other signs of fluid overload and poor perfusion. In contrast, alterations such as sweaty skin or warm and dry skin might not be directly linked to the hemodynamic changes seen in heart failure, while yellowing of the skin typically suggests other pathologies such as liver dysfunction rather than heart failure.