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| __NOTOC__
| | #Redirect [[Congestive heart failure clinical assessment]] |
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| | [[File:Siren.gif|30px|link=Heart failure resident survival guide]]|| <br> || <br>
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| | [[Heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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| {{Congestive heart failure}}
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| {{CMG}}
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| == 2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) <ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= | issue= | pages= | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642 }} </ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID:[http://pubmed.gov/19324967 19324967]</ref>==
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| ===Initial and Serial Evaluation of the HF Patient (DO NOT EDIT)<ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= | issue= | pages= | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642 }} </ref>===
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| |colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' A thorough history and physical examination should be obtained/performed in patients presenting with [[HF]] to identify cardiac and noncardiac disorders or behaviors that might cause or accelerate the development or progression of [[HF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In patients with idiopathic [[DCM]], a 3-generational family history should be obtained to aid in establishing the diagnosis of familial [[DCM]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Volume status and vital signs should be assessed at each patient encounter. This includes serial assessment of weight, as well as estimates of [[jugular venous pressure]] and the presence of [[peripheral edema]] or [[orthopnea]].<ref name="pmid8409071">{{cite journal| author=Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E| title=Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. | journal=J Am Coll Cardiol | year= 1993 | volume= 22 | issue= 4 | pages= 968-74 | pmid=8409071 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8409071 }} </ref><ref name="pmid2913385">{{cite journal| author=Stevenson LW, Perloff JK| title=The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. | journal=JAMA | year= 1989 | volume= 261 | issue= 6 | pages= 884-8 | pmid=2913385 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2913385 }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Initial laboratory evaluation of patients presenting with [[HF]] should include [[complete blood count]], [[urinalysis]], serum electrolytes (including [[calcium]] and [[magnesium]]), [[blood urea nitrogen]], serum [[creatinine]], [[glucose]], fasting [[lipid profile]], [[liver function tests]], and [[thyroid-stimulating hormone]]. Serial monitoring, when indicated, should include serum electrolytes and renal function. A 12-lead [[ECG]] should be performed initially on all patients presenting with [[HF]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' In ambulatory patients with dyspnea, measurement of [[B-type natriuretic peptide|BNP]] or [[B-type natriuretic peptide|N-terminal pro-B-type natriuretic peptide (NT-proBNP)]] is useful to support clinical decision making regarding the diagnosis of [[HF]], especially in the setting of clinical uncertainty.<ref name="pmid16412859">{{cite journal| author=Costello-Boerrigter LC, Boerrigter G, Redfield MM, Rodeheffer RJ, Urban LH, Mahoney DW et al.| title=Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the general community: determinants and detection of left ventricular dysfunction. | journal=J Am Coll Cardiol | year= 2006 | volume= 47 | issue= 2 | pages= 345-53 | pmid=16412859 | doi=10.1016/j.jacc.2005.09.025 | pmc=PMC2647136 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412859 }} </ref><ref name="pmid12215132">{{cite journal| author=Vasan RS, Benjamin EJ, Larson MG, Leip EP, Wang TJ, Wilson PW et al.| title=Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham heart study. | journal=JAMA | year= 2002 | volume= 288 | issue= 10 | pages= 1252-9 | pmid=12215132 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12215132 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'', Measurement of BNP or NT-proBNP is useful for establishing prognosis or disease severity in chronic [[HF]].<ref name="pmid14662703">{{cite journal| author=Tang WH, Girod JP, Lee MJ, Starling RC, Young JB, Van Lente F et al.| title=Plasma B-type natriuretic peptide levels in ambulatory patients with established chronic symptomatic systolic heart failure. | journal=Circulation | year= 2003 | volume= 108 | issue= 24 | pages= 2964-6 | pmid=14662703 | doi=10.1161/01.CIR.0000106903.98196.B6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14662703 }} </ref><ref name="pmid12021226">{{cite journal| author=Berger R, Huelsman M, Strecker K, Bojic A, Moser P, Stanek B et al.| title=B-type natriuretic peptide predicts sudden death in patients with chronic heart failure. | journal=Circulation | year= 2002 | volume= 105 | issue= 20 | pages= 2392-7 | pmid=12021226 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12021226 }} </ref><ref name="pmid18634981">{{cite journal| author=Neuhold S, Huelsmann M, Strunk G, Stoiser B, Struck J, Morgenthaler NG et al.| title=Comparison of copeptin, B-type natriuretic peptide, and amino-terminal pro-B-type natriuretic peptide in patients with chronic heart failure: prediction of death at different stages of the disease. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 4 | pages= 266-72 | pmid=18634981 | doi=10.1016/j.jacc.2008.03.050 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18634981 }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''6.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''7.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''8.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''9.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''10.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
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| |bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1. '''Validated multivariable risk scores can be useful to estimate subsequent risk of mortality in ambulatory or hospitalized patients with [[HF]].<ref name="pmid9193435">{{cite journal| author=Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM| title=Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. | journal=Circulation | year= 1997 | volume= 95 | issue= 12 | pages= 2660-7 | pmid=9193435 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9193435 }} </ref><ref name="pmid19168876">{{cite journal| author=Wedel H, McMurray JJ, Lindberg M, Wikstrand J, Cleland JG, Cornel JH et al.| title=Predictors of fatal and non-fatal outcomes in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA): incremental value of apolipoprotein A-1, high-sensitivity C-reactive peptide and N-terminal pro B-type natriuretic peptide. | journal=Eur J Heart Fail | year= 2009 | volume= 11 | issue= 3 | pages= 281-91 | pmid=19168876 | doi=10.1093/eurjhf/hfn046 | pmc=PMC2645061 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19168876 }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Screening for hemochromatosis or HIV is reasonable in selected patients who present with [[HF]].<ref name="pmid21903058">{{cite journal| author=Okonko DO, Mandal AK, Missouris CG, Poole-Wilson PA| title=Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 12 | pages= 1241-51 | pmid=21903058 | doi=10.1016/j.jacc.2011.04.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21903058 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Diagnostic tests for rheumatologic diseases, amyloidosis, or pheochromocytoma are reasonable inpatients presenting with HF in whom there is a clinical suspicion of these diseases.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''6.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''5.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''6.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''7.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: ]])'' <nowiki>"</nowiki>
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| ==Vote on and Suggest Revisions to the Current Guidelines==
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| *[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
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| ==External Links==
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| *[http://circ.ahajournals.org/content/early/2013/06/03/CIR.0b013e31829e8807.full.pdf 2013 ACCF/AHA Guideline for the Management of Heart Failure]<ref name="pmid23747642">{{cite journal| author=Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE et al.| title=2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= | issue= | pages= | pmid=23747642 | doi=10.1016/j.jacc.2013.05.019 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23747642 }} </ref>
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| *[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016.[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>
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| *[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] ''Circulation'' 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586]PMID: [http://pubmed.gov/16160202 16160202]</ref>
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| ==References==
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| {{Reflist|2}}
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