| ** H&P: History of CAD, hypertension, valvular disease, dilated cardiomyopathy (EtOH, Chagas, Coxsackie B), or MI. '''Dyspnea (most sensitive)''', PND, orthopnea, cough, hemoptysis, fatigue; '''S3 (most specific)''', displaced PMI, crackles, signs of right heart failure (S4, JVD, edema) | | ** H&P: History of CAD, hypertension, valvular disease, dilated cardiomyopathy (EtOH, Chagas, Coxsackie B), or MI. '''Dyspnea (most sensitive)''', PND, orthopnea, cough, hemoptysis, fatigue; '''S3 (most specific)''', displaced PMI, crackles, signs of right heart failure (S4, JVD, edema) |
− | ** Dx: LVEF < 40%, enlarged cardiomediastinal silhouette on CXR, elevated BNP | + | ** Dx: Clinical. Supported by TTE (LVEF < 40%), CXR (enlarged cardiomediastinal silhouette on CXR), and labs (elevated BNP) |
| ** Tx: ACEI/ARBs, ARNIs, β blockers, SGLT2 inhibitors, Spironolactone, and LVAD all have mortality benefit; Digoxin and diuretics don't have any mortality benefit but help with symptoms and decrease hospitalizations. For acute exacerbations use LMNOP (lasix, morphine, '''nitrates''', oxygen, positioning). | | ** Tx: ACEI/ARBs, ARNIs, β blockers, SGLT2 inhibitors, Spironolactone, and LVAD all have mortality benefit; Digoxin and diuretics don't have any mortality benefit but help with symptoms and decrease hospitalizations. For acute exacerbations use LMNOP (lasix, morphine, '''nitrates''', oxygen, positioning). |