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The Diagnostic Evaluation of Patients with Heart Failure

  • Chapter
Congestive Heart Failure

Abstract

Sir Thomas Lewis began his seminal text, Diseases of the Heart, emphasizing that the central problem in patients with heart disease is recognizing and quantifying severity of heart failure as early as possible.1 Braunwald highlighted this fact, contemporizing the point by stating “. . . More than a half century later, the situation has changed little, in that a principle complication of virtually all forms of heart disease is heart failure . . .”2 Paul Dudley White may have only slightly overstated the issue when he noted “. . . myocardial insufficiency giving rise to congestive heart failure is the commonest of the important functional disorders of the heart.”3 Obviously, it is important to recognize this condition, although the heart failure syndrome has changed today. Now, patients with heart failure are older, have more ischemic heart disease, less valvular pathology, and are on many medications.4

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References

  1. Lewis T. Diseases of the heart. New York: MacMillan; 1933.

    Google Scholar 

  2. Braunwald E. Heart disease. A textbook of cardiovascular medicine. 3rd ed. Philadelphia: Saunders; 1988.

    Google Scholar 

  3. White PD. Heart disease. 3rd ed. New York: MacMillan; 1947.

    Google Scholar 

  4. Kannel WB. Epidemiologic aspects of heart failure. In Weber KT, ed. Heart failure; current concepts and management cardiology. Cardiology Clinic Series. Philadelphia: Saunders; 1989.

    Google Scholar 

  5. Hope JA. Treatise on the diseases of the heart and great vessels. London: William Kidd; 1832.

    Google Scholar 

  6. Braunwald E. Clinical Manifestation of heart failure. In Braunwald E, ed. Heart disease: a textbook of cardiovascular medicine. 3rd ed. Philadelphia: Saunders; 1988.

    Google Scholar 

  7. Mackenzie J. Disease of the heart. 3rd ed. London: Oxford University Press; 1913.

    Google Scholar 

  8. Rushmer RF. Cardiac compensation, hypertrophy, and myopathy, and congestive heart failure. In Rushmer RF, ed. Cardiovascular dynamics. Philadelphia: Saunders; 1976.

    Google Scholar 

  9. Gibson GR. Enalapril-induced cough. Arch Intern Med. 1989;149:2701–2703.

    Article  PubMed  CAS  Google Scholar 

  10. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991; 325:293–302.

    Article  Google Scholar 

  11. Poole-Wilson PA, Buller NP. Cases of symptoms in chronic congestive heart failure and implications for treatment. Am J Cardiol. 1988;62:31A.

    Article  PubMed  CAS  Google Scholar 

  12. Braunwald E, Grossman W. Clinical aspects of heart failure. In Braunwald E, ed. Heart disease: a textbook of cardiovascular medicine. 4th ed. Philadelphia: Saunders; 1991.

    Google Scholar 

  13. Cohn JN, Rector TS. Prognosis of congestive heart failure and predictors of mortality. Am J Cardiol. 1988;62:25A.

    Google Scholar 

  14. Fuster V, Steele PM, Edwards WD, et al. Primary pulmonary hypertension; natural history and the importance of thrombosis. Circulation. 1984;70:580.

    Article  PubMed  CAS  Google Scholar 

  15. Rees PJ, Clark TJH. Paroxysmal nocturnal dyspnea and periodic respiration. Lancet. 1979;2:1315.

    Article  PubMed  CAS  Google Scholar 

  16. McKee PA, Costelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure. The Framingham Study. N Engl J Med. 1971;285:1441.

    Article  PubMed  CAS  Google Scholar 

  17. Chakko S, Woska D, Marinez H, DeMarchena E, Futterman L, Kessler K. Clinical radiographic and hemodynamic correlations in chronic congestive heart failure: conflicting results may lead to inappropriate care. Am J Med. 1991;90:353.

    PubMed  CAS  Google Scholar 

  18. Marantz PR, Alderman MH, Tobin JN. Diagnostic heterogeneity in clinical trials for congestive heart failure. Ann Intern Med. 1988;109:55.

    PubMed  CAS  Google Scholar 

  19. Packer M, Lee WH, Kessler PD, Gottlieb SS, Barnstein JL, Kukin ML. Role of neurohormonal mechanism in determining survival in patients with severe chronic heart failure. Circulation. 1987:75(Suppl 4):80.

    Google Scholar 

  20. Packer M. Potential role of potassium as a determinate of morbidity and mortality in patients with systemic hypertension and congestive heart failure. Am J Cardiol. 1990;65;45E.

    Google Scholar 

  21. Wolke AM, Brooks KM, Schaffauer F. The liver in congestive heart failure. Primary Cardiol. 1982;8:130.

    Google Scholar 

  22. Haber HL, Leary JA, Kessler PD, Kukin ML, Gottlieb SS, Packer M. The erythrocyte sedimentation rate in congestive heart failure. N Engl J Med. 1991;324:353.

    Article  PubMed  CAS  Google Scholar 

  23. Glover L, Boxley WA, Dodge HT. A quantitative evaluation of heart size measurements from chest roentgenograms. Circulation. 1973;47:1289.

    PubMed  CAS  Google Scholar 

  24. Ostojic M, Young JB, Hess KR. Prediction of left ventricular ejection fraction using a unique method of chest x-ray and ECG analysis: a non-invasive index of cardiac performance based on the concept of heart volume and mass interrelationships. Am Heart J. 1989;117:590.

    Article  PubMed  CAS  Google Scholar 

  25. Reichek N, Devereaux RB. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation. 1981;63;1391.

    Article  PubMed  CAS  Google Scholar 

  26. Sullivan W, Vlodaver Z, Tunor N, Long L, Edwards JE. Correlation of electrocardiographic and pathologic findings in healed myocardial infarction. Am J Cardiol. 1978;42;724.

    Article  PubMed  CAS  Google Scholar 

  27. Feigenbaum H. Echocardiography. In Braunwald E, ed. Heart disease. A textbook of cardiovascular medicine. 4th ed. Philadelphia: Saunders; 1991.

    Google Scholar 

  28. Seward JB, Khandheria BK, Oh JK, et al. Transesophageal echocardiography: technique, anatomic correlations, implementation, and clinical applications. Mayo Clin Proc. 1988;63:649.

    PubMed  CAS  Google Scholar 

  29. Strok TV, Muller RM, Piske GJ, Ewart CO, Hochrein H. Non-invasive measurement of left ventricular filling pressures by means of transmitral pulsed Doppler ultrasound. Am J Cardiol. 1989;64:655.

    Article  Google Scholar 

  30. Rokey R, Kuo LC, Zoghbi WA, Limacher MC, Quinones MA. Determination of parameters of left ventricular diastolic filling with pulsed Doppler echocardiography: comparisons with cineangiography. Circulation. 1985;71:543.

    Article  PubMed  CAS  Google Scholar 

  31. Zoghbi WA, Farmer JL, Soto JG, Nelson JG, Quinones MA. Accurate non-invasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation. 1986;73:452.

    Article  PubMed  CAS  Google Scholar 

  32. Young JB, Leon CA, Weilbaecher DA. Endomyocardial biopsy in critically ill patients. The procedure and diagnostic and prognostic potential. Prob Crit Care (Adv Intervent Cardiol). 1988;2:433–462.

    Google Scholar 

  33. Sugishita Y, Kosekt S. Dynamic exercise echocardiography. Circulation. 1979;60:743.

    PubMed  CAS  Google Scholar 

  34. Presti CF, Armstrong WF, Feigenbaum H. Comparison of echocardiography at peak exercise and after bicycle exercise in evaluation of patients with known or suspected coronary artery disease. J Am Soc Echo. 1988;1:119.

    CAS  Google Scholar 

  35. Borer JS, Henry WL, Epstein SE. Echocardiographic observations in patients with systemic infiltrative disease involving the heart. Am J Cardiol. 1977;39:184.

    Article  PubMed  CAS  Google Scholar 

  36. Zaret BL, Wackers FJ, Soufer R. Nuclear Cardiology. In Braunwald E, ed. Heart disease. A textbook of cardiovascular medicine. 4th ed. Philadelphia: Saunders; 1991.

    Google Scholar 

  37. Cohn JN, Johnson G, and The Veterans Administrative Study Group. Heart failure with normal ejection fraction. Circulation. 1990;81(Suppl III):4A.

    Google Scholar 

  38. Chan SY, Brunken RC, Buxton DB. Cardiac positron emission tomography. The foundations and clinical applications. J Thorac Imag. 1990;5:9.

    Article  CAS  Google Scholar 

  39. Schelbert HR, Buxton D. Insights into coronary artery disease gained from metabolic imaging. Circulation. 1988;78:496.

    Article  PubMed  CAS  Google Scholar 

  40. Morris CK, Veshna K, Kawaguchi T, Hideg A, Froelich V. The prognostic value of exercise capacity: a review of the literature. Am Heart J. 1991;122:1423.

    Article  PubMed  CAS  Google Scholar 

  41. Jette M, Sidney K, Blumchen G. Metabolic equivalent (METs) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. 1990;13:555.

    Article  PubMed  CAS  Google Scholar 

  42. Weber KT, Janicki JS. Cardiopulmonary exercise testing: physiologic principles and clinical applications. Philadelphia: Saunders; 1986.

    Google Scholar 

  43. Pratt CM, Francis MJ, Seals AA, Zohgbi W, Young JB. Antiarrhythimic and hemodynamic evaluation of indecainide and procainamide in nonsustained ventricular tachycardia. Am J Cardiol. 1990;66:68.

    Article  PubMed  CAS  Google Scholar 

  44. Rouse RA, Kusimi F, Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J. 1973; 85:546.

    Article  Google Scholar 

  45. Grossman W, Bain DS. Cardiac catheterization, angiography, and intervention. 4th ed. Philadelphia: Lea & Feibiger; 1991.

    Google Scholar 

  46. Maeda M, Yokoto M, Iwase M, Miyahara T, Hayashi H, Sotobata I. Accuracy of cardiac output measured by continuous wave Doppler echocardiography during dynamic exercise testing in the supine position in patients with coronary artery disease. J Am Coll Cardiol. 1989;13:76.

    Article  PubMed  CAS  Google Scholar 

  47. Gollub SV, Elkayam U, Young JB, Miller LW, Haffey KA, for the Dopexamine Investigators and their associates. Efficacy and safety of the short term (six hours) intravenous infusion of dopexamine in patients with severe congestive heart failure: a randomized, double-blind, parallel, placebo-controlled multi-centered study. J Am Coll Cardiol. 1991;18:383.

    Article  PubMed  CAS  Google Scholar 

  48. Young JB, Leon CA, Lawrence EC, Whisennand HH, Noon GP, DeBakey ME. Heart replacement for terminal cardiac disease: cardiac transplantation and mechanical sustenance of the cardiovascular system (Parts I and II). Baylor Cardiology Series. 1989;12:4.

    Google Scholar 

  49. Langer A, Freeman MR, Armstrong PW. ST segment shift in unstable angina; pathophysiology in association with coronary anatomy in hospital outcome. J Am Coll Cardiol. 1989;13:1495.

    Article  PubMed  CAS  Google Scholar 

  50. Kennedy HL. Long term (Holter) electrocardiogram recordings. In Zipes DP, Jalif J, eds. Cardiac electrophysiology. From cell to bedside. Philadelphia: Saunders; 1990.

    Google Scholar 

  51. Dressler W. Pulsations of the cervical veins and liver. In Dressler W, ed. Clinical aids in cardiac diagnosis. New York: Grune and Stratton; 1970.

    Google Scholar 

  52. Constant J. Bedside cardiology. 3rd ed. Boston: Little, Brown. 1985.

    Google Scholar 

  53. Swartz MH. Jugular venous pressure pulse: its value in cardiac diagnosis. Primary Cardiol. 1982;8:197.

    Google Scholar 

  54. Cohen MV. Correlative atlas of adult cardiac disorders. Noninvasive diagnostic techniques. Mt. Kisco, NY: Futura Publishing. 1980.

    Google Scholar 

  55. Sechtem U, Sommerhoff BA, Markiewicz W. Assessment of regional left ventricular wall thickening by magnetic resonance imaging. Evaluation in normal persons and patients with global and regional dysfunction. Am J Cardiol. 1987;57:154.

    Google Scholar 

  56. Busser PT, Aufferman W, Holt WW, et al. Non-invasive evaluation of global left ventricular function with use of sine nuclear magnetic resonance. J Am Coll Cardiol. 1989;13:1294.

    Article  Google Scholar 

  57. Sechtem U, Pflugfelder P, Gould R. Measurement of right and left ventricular volumes in healthy individuals with sine MR imaging. Radiology. 1987;163:697.

    PubMed  CAS  Google Scholar 

  58. Higgins CB, Byrd BF, McNamara MT. Magnetic resonance imaging of the heart: a review of the variance in 172 subjects. Radiology. 1985;15:671.

    Google Scholar 

  59. Rumberger JA, Feiring AJ, Reiter SJ. Ultra-fast computed tomography: evaluation of global left ventricular anatomy and function. In Pohost GM, ed. New concepts in cardiac imaging. Chicago: Year Book. 1988.

    Google Scholar 

  60. Poole-Wilson PA, Buller NP. Causes of symptoms in chronic congestive heart failure and implications for treatment. Am J Cardiol. 1988;62:31A.

    Google Scholar 

  61. Petermann W, Barth J, Entzian P. Heart failure in airway obstruction. Int J Cardiol. 1987;17:207.

    Article  PubMed  CAS  Google Scholar 

  62. Wasserman D. Dyspnea on exertion: is it the heart or the lungs? JAMA. 1982;248:2042.

    Google Scholar 

  63. Szatalowicz VL, Arnold PE, Chaimovitz C, Bichet D, Beri T, Schrier RW. Radioimmunoassay of plasma arginine vasopressin in hyponatremic patients with congestive heart failure. N Engl J Med. 1981;305:263.

    Article  PubMed  CAS  Google Scholar 

  64. Birch GE, Giles TD. The importance of magnesium deficiency in cardiovascular disease. Am Heart J. 1911; 94:649.

    Article  Google Scholar 

  65. Blasco W. Features of hepatic involvement in congestive heart failure. Cardiovasc Rev Ret. 1983;4:963.

    Google Scholar 

  66. Berkowitz D, Croll MN, Likoff W. Malabsorption as a complication of congestive heart failure. Am J Cardiol. 1963;11:43.

    Article  PubMed  CAS  Google Scholar 

  67. Pittman JG, Cohen P. The pathogenesis of cardiac cachexia. N Engl J Med. 1964;27:403.

    Article  Google Scholar 

  68. Cohn JN, Rector TS. Prognosis of congestive heart failure and predictors of mortality. Am J Cardiol. 1988;62:25A.

    Google Scholar 

  69. Mason JW, O’Connell JB. Clinical merit of endomyocardial biopsy. Circulation. 1989;79:971.

    Article  PubMed  CAS  Google Scholar 

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Young, J.B., Farmer, J.A. (1994). The Diagnostic Evaluation of Patients with Heart Failure. In: Hosenpud, J.D., Greenberg, B.H. (eds) Congestive Heart Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8315-4_32

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  • DOI: https://doi.org/10.1007/978-1-4613-8315-4_32

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-8317-8

  • Online ISBN: 978-1-4613-8315-4

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