Consider primarily among persons with other cardiovascular risk factors (especially age).Symptoms:
- Dyspnea (often only on exertion)
- Orthopnea, Paroxysmal Nocturnal Dyspnea, Pedal Edema
- Chest Pain (“pressure” / “tightness” / “discomfort”) — i.e. Sx of recent MI.
- If cough: primarily nocturnal
- Bibasilar rales, JVD, Hepatojugular Reflux, S3 or S4, Pedal Edema
- Valvular Lesions, Arrhythmias (potential causes of CHF)
- Serum BNP (Brain-type Natriuretic Peptide)
- EKG (for recent MI)
- Echo (clinical gold standard for ventricular function)
- Cardiac: M.I., Valve Disorder, Arrhythmia, Hypertension
- Viral Myocarditis (if failure occurs in young people)
- Cardiomyopathy (alcohol, toxic, collagen-vascular, metabolic diseases)
- Renal Failure, Anemia
See postings Acute Dyspnea – 3 and Chronic Dyspnea – 1.