Which symptom is typically NOT associated with congestive heart failure?

In congestive heart failure (CHF), symptoms typically arise from the body's inability to effectively pump blood, leading to a buildup of fluid and a range of systemic responses. Increased energy levels are not a symptom associated with CHF; rather, patients usually experience fatigue and decreased exercise tolerance. This is due to the heart's reduced ability to provide sufficient blood flow to meet the body's demands, particularly during activities that require increased oxygen and nutrients.

Swelling in the legs, frequent urination at night, and shortness of breath with exertion are all common symptoms of congestive heart failure. Swelling, or peripheral edema, occurs because of fluid retention when the heart fails to efficiently pump blood, causing fluid to accumulate in the lower extremities. Frequent nighttime urination, known as nocturia, can happen due to increased venous return when lying down, which can lead to excess fluid being processed by the kidneys. Lastly, shortness of breath during exertion is a result of pulmonary congestion as fluid backs up into the lungs, limiting oxygen exchange and leading to difficulty breathing during physical activity.

Thus, the lack of elevated energy levels in a patient with CHF clearly distinguishes it from the other symptoms associated with this condition.