Noninvasive diagnostic evaluation of the acute heart failure patient with systolic dysfunction: focus on the electrocardiogram and chest x-ray

The emergency department (ED) plays a key role in the initial diagnosis and management of acute heart failure (AHF). Despite the advent of novel biomarkers and traditional methods of assessment, such as history, examination, and chest X-ray, diagnosis of the dyspnoeic ED patient is, at times, very challenging. Focused cardiac and pulmonary ultrasound has emerged as a valid, facile and efficient method to aid in the initial diagnosis and management of AHF.

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Diagnostic Accuracy of Lung Point-Of-Care Ultrasonography for Acute Heart Failure Compared With Chest X-Ray Study Among Dyspneic Older Patients in the Emergency Department

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2021.02.019 ◽

2021 ◽

Author(s):

Shunichiro Nakao ◽

Christian Vaillancourt ◽

Monica Taljaard ◽

Marie-Joe Nemnom ◽

Michael Y. Woo ◽

...

Keyword(s):

Heart Failure ◽

Emergency Department ◽

Diagnostic Accuracy ◽

Acute Heart Failure ◽

Older Patients ◽

Point Of Care ◽

X Ray ◽

Chest X Ray ◽

Point Of Care Ultrasonography ◽

Lung Point

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Chest X-Ray in Acute Heart Failure

Acute Heart Failure ◽

10.1007/978-1-84628-782-4_46 ◽

2008 ◽

pp. 494-499

Author(s):

Laurence Monnier-Cholley

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

X Ray ◽

Chest X Ray

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Life-threatening Takotsubo Cardiomyopathy

The American Heart Hospital Journal ◽

10.15420/ahhj.2011.9.2.119 ◽

2011 ◽

Vol 9 (2) ◽

pp. 119 ◽

Cited By ~ 4

Author(s):

Karen Mrejen-Shakin ◽

Ricardo Lopez ◽

Mohandas M Shenoy ◽

◽

...

Keyword(s):

Heart Failure ◽

Left Ventricle ◽

Acute Heart Failure ◽

Takotsubo Cardiomyopathy ◽

Stress Test ◽

Systolic Dysfunction ◽

Apical Ballooning ◽

Assisted Ventilation ◽

Two Dimensional ◽

Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

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Impact of Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptors Blockers on Mortality in Acute Heart Failure Patients with Left Ventricular Systolic Dysfunction in the Middle East: Observations from the Gulf Acute Heart Failure Registry (Gulf CARE)

Current Vascular Pharmacology ◽

10.2174/1570161115666170817164420 ◽

2018 ◽

Vol 16 (6) ◽

pp. 596-602

Author(s):

Ibrahim Al-Zakwani ◽

Kadhim Sulaiman ◽

Jawad A. Al-Lawati ◽

Alawi A. Alsheikh-Ali ◽

Prashanth Panduranga ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Enzyme Inhibitors ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Angiotensin Converting Enzyme Inhibitors ◽

Left Ventricular ◽

Angiotensin Receptors ◽

Ventricular Systolic Dysfunction ◽

Converting Enzyme Inhibitors

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NT-proBNP and Echocardiographic Parameters in Patients with Acute Heart Failure

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.59 ◽

2007 ◽

Vol 50 (1) ◽

pp. 51-56 ◽

Cited By ~ 5

Author(s):

Radek Pudil ◽

Miloš Tichý ◽

Rudolf Praus ◽

Václav Bláha ◽

Jan Vojáček

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Acute Heart Failure ◽

Vena Cava ◽

Left Ventricular ◽

Clinical Severity ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

X Ray ◽

Cardiothoracic Ratio

Aim. The aim of this study was to analyse the relation between clinical, haemodynamic and X-ray parameters and plasma NT-proBNP level in pts with symptoms of left ventricular dysfunction. Methods. The plasma NT-proBNP levels, chest x-ray, transthoracic 2-d and Doppler echocardiography were performed at the time of admission in a group of 96 consecutive patients (mean age 68 ± 11 years) with symptoms of acute heart failure. NT-proBNP levels were assessed with the use of commercial tests (Roche Diagnostics). Results. All patients have significant increase in NT-proBNP (8 000 ± 9 000 pg/mL vs. controls 90 ± 80 pg/mL, p < 0.001). The group of all patients has shown a significant increase in cardiothoracic ratio (CTR, 0.6 ± 0.1, vs. 0.4 ± 0.1, p <0.001), left atrium diameter (LAD, 4.4 ± 0.8 cm, vs.3.5 ± 0.4 cm, p <0.01). Left ventricular ejection fraction (LVEF) was decreased (37 ± 15%, vs. 64 ± 5%, p <0.001). In patients with acute heart failure, NT-proBNP significantly correlated with end-systolic and end-diastolic left ventricle diameters, ejection fraction, vena cava inferior diameter and plasma creatinine levels. Conclusion. Increased plasma NT-proBNP level is influenced by the clinical severity of acute heart failure and correlates with LVEF and IVCD. NT-proBNP can serve as a marker for the clinical severity of the disease.

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