Table 1 Diagnostic assessments according to guidelines Assessments to be performed routinely to establish the presence and likely cause of heart failure (Eur Soc Cardiol 2001).
From: General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study
Assessments | The diagnosis of heart failure | Suggests alterantive or additional diagnosis | ||
|---|---|---|---|---|
Necessary | Supports | Opposes | ||
Appropriate symptoms | +++ | +++ (if absent) | ||
Appropriate signs | +++ | + (if absent) | ||
Cardiac dysfunctioning on imaging (usually echocardiography) | +++ | +++ (if absent) | ||
Response of symptoms or signs to therapy | +++ | +++ (if absent) | ||
Electrocardiography | +++ (if normal) | |||
Chest X-ray | + (if pulmonary congestion or cardiomegaly) | + (if normal) | Pulmonary disease | |
Full blood count* | Anemia/secondary polycythemia | |||
Biochemistry and urinalysis* | Renal or hepatic disease/diabetes | |||
Plasma concentration of natriuretic peptides in untreated patients (where available)* | + (if elevated) | +++ (if normal) | ||