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![Diagnostic assessments in patient with suspected heart failure (non acute onset) according to the ESC guidelines (2016) [1]](publication/317343347/figure/tbl1/AS:669237341339652@1536570024468/Diagnostic-assessments-in-patient-with-suspected-heart-failure-non-acute-onset.png)
Diagnostic assessments in patient with suspected heart failure (non acute onset) according to the ESC guidelines (2016) [1]
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A contemporary review of the diagnosis of heart failure as part of a special heart failure issue. The 2016 ESC heart failure guidelines have provided updated evidence-based recommendations for the clinical diagnosis of heart failure. This article summarises the diagnostic process in the case of a patient presenting with acute dyspnoea and suspected...
Contexts in source publication
Context 1
... 1 summarises the diagnostic process in the case of a patient presenting with acute dyspnoea and suspected acute heart failure. Table 1 summarises the diagnostic elements that should be assessed in a patient with non-acute onset, as described below. The diagnostic process is illustrated in an algorithm developed by the ESC with an adaption shown in Figure 1. ...
Context 2
... patients with non-acute onset, presenting with symptoms or signs of heart failure non-urgently in primary care or in a hospital outpatient clinic, the probability of heart failure should first be evaluated by assessing history and symptomatology and with physical examination (Table 1). During these steps, at least one element should be abnormal to continue to consider a diagnostic hypothesis of heart failure (Figure 1). ...
Context 3
... prior diagnosis of heart failure, diabetes, hypertension, valvular heart disease, advanced age, male sex, and obesity have all been found to predict the fluid or volume overload typical of congestive heart failure. [6,7] For these reasons, the first diagnostic step is to assess the probability of heart failure and this consists of the evaluation of a potential history of coronary artery disease, arterial hypertension, diuretic use, orthopnoea/paroxysmal nocturnal dyspnea, and other conditions ( Table 1). Knowledge of the precipitating causes may also have therapeutic and prognostic implications. ...
Context 4
... laboratory investigations can also direct the clinician to explore alternative diagnoses and highlight potentially modifiable causes of heart failure. [4,5] As aforementioned, plasma NPs should be measured after the first diagnostic steps shown in Table 1 and Figure 1. According to the ESC guidelines, the measurement of NPs should be used to rule out heart failure, and not to establish the diagnosis. ...
Context 5
... to the ESC guidelines, the measurement of NPs should be used to rule out heart failure, and not to establish the diagnosis. Other laboratory exams that should be performed primarily to rule out heart failure are listed in Table 1. ...
Similar publications
Heart failure remains a global burden despite important progress that has been made in the management of heart failure. Guidelines from ESC and AHA are still widely used as a guidance for diagnosis and management of heart failure. We will discuss the new recommendation from ESC and AHA guideline for heart failure.
Citations
... Heart Failure (HF) is a cardiac structural and/or functional abnormality leading to failure of the heart to deliver oxygen at a rate commensurate with the requirements of the metabolizing tissues [1] . Diagnosis of HF is confirmed based on clinical history, physical examination (Framingham criteria), chest X-ray and echocardiography findings and laboratory exams specifically plasma B-type Natriuretic Peptide and N-terminal B-type Natriuretic Peptide measurement [2,3] . Clinical outcomes among patients with HF were mortality (all-cause and HF specific death), hospitalization, readmission and morbidity endpoints used in different trials and taken as definition by the European Society of Cardiology HF association consensus document [4] . ...
Background: Heart Failure (HF) is associated with severe complications,
... Heart failure (HF) is a cardiac structural and/or functional abnormality leading to failure of the heart to deliver oxygen at a rate commensurate with the requirements of the metabolizing tissues [1]. Diagnosis of HF is con rmed based on clinical history, physical examination (Framingham criteria), chest X-ray and echocardiography ndings and laboratory exams speci cally plasma B-type Natriuretic Peptide and Nterminal B-type Natriuretic Peptide measurement [2,3]. Clinical outcomes among patients with HF were mortality (all-cause and HF speci c death), hospitalization, readmission and morbidity endpoints used in different trials and taken as de nition by the European Society of Cardiology HF association consensus document [4]. ...
Background: Heart failure (HF) is associated with severe complications, hospitalization, and poor quality of life. Patients with heart failure had poor physical and emotional symptoms, functional status and worse health outcomes.
Objective: The aim of this systematic review and meta-analysis will be to investigate whether pharmacist intervention is effective in improving health related quality of life (HRQoL) and clinical outcomes among patients with heart failure.
Method: Systematic review and meta-analysis will be conducted. Published journals in English and indexed in Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Google scholar will be searched from 1990 to December 2019. Data will be extracted by one author and will be approved by other two authors independently. Data will be analyzed in accordance with the Cochrane handbook. Standardized mean differences will be used as an estimate of the effect size. Quality of included studies will be assessed using the modified Downs and Black checklist. Analysis for the dichotomous outcome studies will be converted into standardized mean difference and present with 95% confidence intervals. The review is approved in the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42020158236.
Discussion: Currently there are important gaps on the effectiveness of pharmacist intervention in improving health-related quality of life and clinical outcomes. We believe this review will provide comprehensive evidence on the effectiveness of pharmacist intervention among patients with HF.
... Dyspnea will get worse while physical activity increase or a flat body position. 26 In addition, CHF also causes changes in neurohormonal regulation so that it will affect the hemodynamic status which can be seen from the instability of the patient's vital signs, 27 as the result it will emerge typical signs of heart failure such as tachycardia, tachypnea, rhythmic breath sounds, effusion pleura, increased jugular vein, peripheral edema and hepatomegaly (Indonesian Cardiovascular Specialist Association, 2015). Symptoms worsen even increase the risk of cardiovascular morbidity and mortality if the treatment does not appropriate. ...
Background: Changes in vital signs such as tachycardia, dyspnea, tachipnea, decreased oxygenation, caused by the inability of the heart to pump enough blood to meet the needs of oxygen and nutrients needed by the tissue, so that alternative therapies are needed: alternate nostril breathing exercise (ANBE) as a companion to pharmacological therapy for congestive heart failure (CHF) patients. The purpose of this study was to see the effect of ANBE on the vital sign of CHF patients.Methods: This Quasy experimental study was used one group pretest and Posttes design, conducted at one of the Padang City Hospitals from March to August 2019. Study population includes CHF sufferers, with a sample of 16 people, using accidental sampling technique. Univariate data analysis to get the mean of vital sign and bivariate measurements using parametric test i.e. Paired t-test to see the effect of this therapy.Results: Mean vital signs pretest and posttest was given in a row The observations are: respiratory rate (RR): 5.4978; 4.6078, pulse: 10.1804; 8,7770, systolic blood pressure (SBP): 12,5963; 11,1481, and diastolic blood pressure (DBP): 10,3009; 8.8606. Paired t-test obtained p-value of RR, pulse, SBP and DBP: 0.000, and existing t count> from t table (t count> 2.13145), so that there is an effect of ANBE on vital signs.Conclusions: ANBE affects the vital sign of CHF patients and can be continued as an intervention that can be carried out independently by CHF sufferers.
... In heart failure (HF) one of the main reasons for hospitalization is congestion. 1,2 Both the congestion itself as well as the diuretic drugs used to treat it can have a detrimental impact on renal function. As such, optimized monitoring of renal function in HF is pivotal for preventing renal failure and emergency re-hospitalization. ...
Congestion, renal function, and electrolyte imbalance (particularly potassium) are common problems in the management of the complex multi-morbid patient with heart failure (HF). Poor control of these fundamental clinical features is associated with adverse outcomes. Close monitoring of serum potassium and renal function is recommended by most current guidelines during the management of an episode of acute decompensated HF, yet the recommendations remain poorly implemented. Physicians are advised to treat a state of euvolaemia after an admission with decompensated HF and residual congestion is a marker of worse outcome, yet control of congestion is poorly assessed and managed in real-world practice. This document reflects the key points discussed by a panel of experts during a Heart Failure Association meeting on physiological monitoring of the complex multi-morbid HF patient, and here, we present to aspects related to renal function, electrolyte, and congestion monitoring.
... Schwinger RH and Erdmann et al [11] suggested the same. Another study by Cirstianavitale and Ilariaspoletini et al suggested that nearly 60% of the patients diagnosed with heart failure have coronary artery disease and in patients with acute coronary syndromes, myocardial ischemia is often a precipitant factor [12] which is in accordance to our study, concluded that majority of the patients with CAD has occurrence of CHF. In our study the average number of drugs per prescription was found to be 12.01 which is in concordance with the study conducted by Prasannakumar B et al [13] . ...
... Natriuretic peptides are useful biomarkers in patients with heart failure. The ventricles of heart release BNP and N-terminal pro-BNP (NT-pro BNP) when volume and pressure overloaded [19]. ...
... Chest X-ray can be valuable to rule out other pathology that may be responsible for symptoms, such as breathlessness. Chest X-ray may show features of heart failure such as an increased cardiothoracic ratio, lung interstitial oedema or bilateral pleural effusions [1,19,20]. ...
... ECG can use for identification of changes such as left bundle branch block, left ventricular hypertrophy, acute or previous myocardial infarction, or atrial fibrillation and may advice for further investigation by echocardiography, stress testing, or cardiology consultation. Minor abnormalities on ECG make systolic heart failure and presence of other findings such as atrial fibrillation, new T-wave changes, or any abnormality has a small effect on the diagnostic probability of heart failure [19,20]. ...
Review Article Heart failure is a clinical syndrome caused by structural or functional abnormalities of myocardium resulting in the inability of the heart to meet the oxygen demands of the body. In the developed countries approximately 1-2% of the adult population and globally more than 26 million people affected by Heart failure. It is estimated that about 5.7 million adults within the United States are diagnosed with heart failure. In all deaths, across the nation one in nine deaths enclosed failure as a contributive cause. Annually more than 870,000 new cases of heart failure are diagnosed, and it's calculatetable that by the year 2030 bigger than eight million individuals can be diagnosed with the disease. The burden of HF in India appears high, and estimates of prevalence range from 1.3 million to 4.6 million, with an annual incidence of 491 to 600-1.8 million. The most commonly reported signs and symptoms are breathlessness, fluid retention, and paroxysmal nocturnal dyspnoea (PND). Other symptoms such as a poor appetite and low energy levels can be related to heart failure but they are also associated with other conditions. The diagnosis of Heart Failure is performed by using various parameters like blood test, chest x-ray, ECG, Echocardiography. The objectives of pharmacotherapy for heart failure are to prevent complications and reduce morbidity. Drugs used for management of heart failure are Angiotensin-converting enzyme, Beta-blockers, Angiotensin receptor blocker, Mineralocorticoid receptor antagonist, Angiotensin receptor neprilysin inhibitor, diuretics and others. In this review we are providing latest news on heart failure, signs and symptoms, different assessment tools, current practices regarding the management of heart failure.
... Schwinger RH and Erdmann et al [11] suggested the same. Another study by Cirstianavitale and Ilariaspoletini et al suggested that nearly 60% of the patients diagnosed with heart failure have coronary artery disease and in patients with acute coronary syndromes, myocardial ischemia is often a precipitant factor [12] which is in accordance to our study, concluded that majority of the patients with CAD has occurrence of CHF. In our study the average number of drugs per prescription was found to be 12.01 which is in concordance with the study conducted by Prasannakumar B et al [13] . ...
... In addition, knowledge of precipitating conditions may have therapeutic and prognostic implications. Detailed patient history should include identifying and assessing symptomatology [54]. ...
... Presenting symptoms: The assessment of presenting symptoms should complement findings from assessment of detailed history. Characteristic symptoms such as dyspnea, fatigue and signs of volume overload including peripheral edema and pulmonary rales are usually typical consequences of systemic and pulmonary congestion in the setting of elevated LV filling pressures [54]. However, some symptoms such as peripheral edema, exertional dyspnea and fatigue are not very helpful in differential diagnosis since they are non-specific. ...
... In addition to NPs assessment, twelve (12)-lead electrocardiogram (ECG) may be considered to increase the likelihood of LHF diagnosis. ECG is recommended to assess hearth rhythm, heart rate, QRS morphology and QRS duration [54]. It provides additional diagnostic clues and information about etiology such as MI and indications for treatment [7,10]. ...
