Diagnosis of CHF

Diagnosis of CHF - Learning Issue: Diagnosis of CHF-MH Dont...

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Learning Issue: Diagnosis of CHF-MH · Don’t Miss This: Serum BNP, powerful prognosis marker to differentiate dyspnea due to cardiac or non-cardiac problem · Definition: Patients are categorized by the NYHA classification as class I (asymptomatic), Class II (symptomatic with mild activity), class III (symptomatic with moderate activity), and class IV (symptomatic at rest). · Signs & Symptoms: Most common complaint of left heart failure is SOB, initially exertional dyspnea first and then progressing to orthopnea, paroxysmal nocturnal dyspnea, and rest dyspnea. An overlooked symptom is a chronic non-productive cough, which is worse in the recumbent position. Nocturia due to fluid retention during the day and increased renal perfusion. Patients also complain of fatigue and exercise intolerance. Patients with right heart failure have predominate signs of fluid retention, with the patient exhibiting edema, hepatic congestion, and on occasion anorexia and nausea due to edema of the gut or impaired GI perfusion and acities. · What to look for in physical exam:
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Diagnosis of CHF - Learning Issue: Diagnosis of CHF-MH Dont...

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