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| {| class="infobox" style="float:right;" | | {| class="infobox" style="float:right;" |
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| | [[File:Siren.gif|30px|link= Congestive heart failure resident survival guide]]|| <br> || <br> | | | [[File:Siren.gif|30px|link= Heart failure resident survival guide]]|| <br> || <br> |
| | [[Acute decompensated heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | | | [[Heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] |
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| {| class="infobox" style="float:right;"
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| | [[File:Critical_Pathways.gif|88px|link= Congestive heart failure critical pathways]]|| <br> || <br>
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| |} | | |} |
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| {{Congestive heart failure}} | | {{Congestive heart failure}} |
| {{CMG}}; {{AOEIC}} {{LG}} | | {{CMG}}; {{AOEIC}} {{LG}} |
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| ==Symptoms== | | ==Symptoms== |
| * [[Ankle edema]] or [[swelling of the feet]] and legs | | * Table bellow shows [[Symptoms]] and [[sign]]s of [[heart failure]]: |
| * [[Claudication]] or [[pain with walking]] | | {| style="border: 2px solid #4479BA; align="left" |
| * [[Confusion]] and [[altered mentation]] | | ! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Typical symptoms}} |
| * [[Cool extremities]] or [[cold and clammy hands]] | | ! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|More specific signs}} |
| * [[Cyanosis]] or [[bluish color to the skin]] | | |- |
| * [[Dizziness]] | | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Breathlessness]] |
| * [[Dyspnea|Dyspnea on ordinary exertion]] or greater shortness of breath with usual activities | | *[[Orthopnoea]] |
| * [[Fainting]] | | *[[Paroxysmal nocturnal dyspnoea]] |
| * [[Fatigue]] | | *Reduced [[exercise tolerance]] |
| * [[Hemoptysis]] or frothy sputum | | *[[Fatigue]] |
| * [[Nocturia]] or [[urination during the night]] | | *[[Tiredness]] |
| * [[cough|Nocturnal cough]] | | * Increased time to recover after [[exercise]] |
| * [[Orthopnea]] or [[sleeping on pillows]] | | *[[Ankle swelling]] |
| * [[Palpitation]]s or [[extra heart beats]] | | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Elevated [[jugular venous pressure]] |
| * [[Paroxysmal nocturnal dyspnea]] or [[awakening at night with shortness of breath]] | | *[[Hepatojugular reflux]] |
| * [[Shortness of breath]] | | *[[Third heart sound]] ([[gallop rhythm]]) |
| * [[Syncope]] or [[passing out]] | | *Laterally displaced [[apical impulse]] |
| * [[Weakness]] | | |
| * [[Wheezing]] or cardiac asthma | | |- |
| | ! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Less typical symptoms}} |
| | ! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|Less specific signs}} |
| | |- |
| | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Nocturnal cough]] |
| | *[[Wheezing]] |
| | *[[Bloated]] feeling |
| | *Loss of [[appetite]] |
| | *[[Confusion]] (especially in the [[elderly]]) |
| | *[[Depression]] |
| | *[[Palpitation]] |
| | *[[Dizziness]] |
| | *[[Syncope]] |
| | *[[Bendopnea]] |
| | | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | [[Weight gain]] (>2 kg/week) |
| | *[[Weight loss]] (in advanced [[HF]]) |
| | *Tissue [[wasting]] ([[cachexia]]) |
| | *[[Cardiac murmur]] |
| | *[[Peripheral oedema]] ([[ankle]], [[sacral]], [[scrotal]]) |
| | *[[Pulmonary crepitations]] |
| | *[[Pleural effusion]] |
| | *[[Tachycardia]] |
| | *[[Irregular pulse]] |
| | *[[Tachypnoea]] |
| | *[[Cheyne-Stokes respiration]] |
| | *[[Hepatomegaly]] |
| | *[[Ascites]] |
| | *[[Cold extremities]] |
| | *[[Oliguria]] |
| | *Narrow [[pulse pressure]] |
| | |- |
| | |} |
| | {| |
| | ! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 ESC Guideline |
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| | |}<ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref> |
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| ===Symptoms of Left Sided Congestive Heart Failure=== | | ===Symptoms of Left Sided Congestive Heart Failure=== |
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| *'''[[New york heart association functional classification#New York Heart Association Functional Classification (NYHA)|NYHA IV]]:''' Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency present at rest. | | *'''[[New york heart association functional classification#New York Heart Association Functional Classification (NYHA)|NYHA IV]]:''' Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency present at rest. |
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| ==2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT)<ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. 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. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</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 Clinical Assessment of Patients Presenting With Heart Failure (DO NOT EDIT)<ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. 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. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</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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| {|class="wikitable"
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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 [[Congestive heart failure physical examination|physical examination]] should be obtained/performed in patients presenting with [[heart failure]] to identify cardiac and noncardiac disorders or behaviors that might cause or accelerate the development or progression of [[heart failure]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A careful history of current and past use of [[alcohol]], illicit drugs, current or past standard or ''alternative therapies,'' and [[chemotherapy]] drugs should be obtained from patients presenting with [[heart failure]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| === Serial Clinical Assessment of Patients Presenting With Heart Failure (DO NOT EDIT)<ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. 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. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</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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| {|class="wikitable"
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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.''' Careful history of current use of [[alcohol]], [[tobacco]], illicit drugs, ''alternative therapies,'' and [[chemotherapy]] drugs, as well as diet and [[sodium]] intake, should be obtained at each visit of a patient with [[heart failure]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <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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| ==Sources==
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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="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. 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. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</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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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
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