Chapter

Basic investigation of heart failure

Roy S. Gardner

in Oxford Textbook of Heart Failure

Published on behalf of Oxford University Press

ISBN: 9780199577729
Published online July 2011 | e-ISBN: 9780199697809 | DOI: http://dx.doi.org/10.1093/med/9780199577729.003.0018

Series: Oxford Textbooks

Basic investigation of heart failure

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Although the clinical history and examination may suggest adiagnosis of heart failure (HF), objective evidence of cardiacdysfunction is also required. A number of diagnostic tests can bereliably employed to identify patients with left ventricular systolicdysfunction (LVSD). However, HF with preserved systolic functionis less reliably pinpointed, particularly as the syndrome isa mixed bag of conditions rather than a specific entity.As well as investigating patients to identify the presence andseverity of cardiac dysfunction and any relevant comorbidities, itis important to clarify the underlying aetiology. Some causes arepotentially correctable with possible improvement in the degreeof cardiac dysfunction. Appropriate investigations will also helpto risk-stratify patients, identifying those suitable for advancedtherapies such as device therapy (ICD, CRT, VAD) and cardiactransplantation.Although echocardiography is currently the principal diagnostictest for patients with HF, cardiac magnetic resonance imaging(CMR) is now considered to be the ‘gold standard’ method ofassessing cardiac function. The investigations that should be done,or at least considered, in the patient suspected of having HF are shown in Table 18.1. This chapter concentrates on the first-lineinvestigations.

Chapter.  4856 words.  Illustrated.

Subjects: Cardiovascular Medicine

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