Sandbox:chf

chf

Organ System	Disease	Symptoms	Signs	Laboratory findings	Diagnostic modality	Management
Cardiac	HFpEF	Exertional dyspnea, reduced exercise tolerance, orthopnea, paroxysmal nocturnal dyspnea, edema	Elevated JVP, fine crackles, edema	Increased BNP	Echocardiography (normal EF)	Control of volume overload and hypertension, treatment of underlying condition (obesity, AF, coronary artery disease, anemia)
	HFrEF	Exertional dyspnea, reduced exercise tolerance, orthopnea, paroxysmal nocturnal dyspnea, edema	Elevated JVP, fine crackles, edema	Increased BNP	Echocardiography (reduced EF)	Diuretics, ACE inhibitors, ARBs, beta blockers, nitrates
	Pericardial disease	Exercise intolerance, dyspnea, fatigue	Elevated JVP, pericardial knock, kussmaul's sign, pulsus paradoxus	-	Echocardiography, ECG	Diuretics, pericardiectomy
	Hypertrophic cardiomyopathy	Dyspnea, chest pain, palpitation, lightheadedness	Systolic murmur	-	Echocardiography, ECG	Beta blockers, verapamil
	Valvular disease (MR, TR)	Edema, fatigue, exercise intolerance, dyspnea, lightheadedness	Cardiac murmur	-	Echocardiography, ECG	Valve repair or replacement, diuretics, beta blockers
	Arrhythmia	Palpitation, lightheadedness, chest tightness	Tachycardia, abnormal pulse	-	Echocardiography, ECG, holter monitoring	Pharmacological cardioversion (anti arrhythmics), electrical cardioversion, ablation
Pulmonary	Chronic airway disease	Cough, dyspnea, chest pain, exercise intolerance	Tachypnea, respiratory distress, cyanosis, edema, rhonchi and crackles	Hypoxemia, hypercapnea, polycythemia,	PFT, chest imaging	Bronchodilators, corticosteroids, anticholinergics
	Interstitial lung diseaee	Exercise intolerance, cough	Crackles, clubbing, cyanosis	Hypoxemia	PFT, Chest imaging, lung biopsy	Corticosteroids, bronchodilators
	Pulmonary hypertension	Dyspnea, fatigue, chest pain, syncope, palpitation	Edema, clubbing, elevated JVP, TR murmur	Elevated BNP, elevated d-dimer	Echocardiography, cardiac cathaterization	Diuretics, calcium channel blockers, endothelin receptor antagonist, phosphodiesterase 5 inhibitor
	Sleep apnea	Snoring, somnolence, headache, fatigue, irritability	tachypnea, hypertension, tachycardia	Hypoxemia, polycythemia	Polysomnography	Weight reduction, CPAP
High output status	Anemia	Palpitation, lightheadedness, fatigue	Cheilosis, delayed capillary refill	Decreased Hb and HCT	CBC, Iron study, bone marrow aspiration and biopsy	Iron replacement, nutritional support
	Thyrotoxicosis	Palpitation, sweating, weight loss	Proptosis, tachycardia	Decreased TSH, increased T3,T4	Thyroid function test	Thyrostatics, beta blockers, ablation
Others	Liver disease	Fatigue, edema, jaundice	Ascites, palmar erythema, gynecomastia	Increased AST and ALT, decreased albumin, increased Br	Liver function test, Liver biopsy	Diuretics, treatment of underlying disease
	Chronic kidney disease	Fatigue, anorexia, nausea, edema, decreased exercise tolerance	Edema, hypertension, crackles	Increased BUN and Cr	BUN, Cr	Control of blood pressure, anemia, dialysis, kidney transplant