Society guidelinesThe 2012 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: Focus on Acute and Chronic Heart Failure
Section snippets
Diagnosis, evaluations, and investigation
The diagnosis of AHF is based on a constellation of symptoms (eg, orthopnea and shortness of breath on exertion) and signs (eg, edema and respiratory crackles).2, 3 Physical examination evaluates systemic perfusion and presence of congestion (cold or warm, wet or dry; Supplemental Figure S1).3, 4, 5, 6 Laboratory testing, electrocardiogram (ECG), chest x-ray, and echocardiogram are all important to obtain.5 A slight mild elevation of cardiac troponin is not infrequently observed in acute
Diagnosis, evaluation, and investigation
The diagnosis of HF is made when symptoms and physical signs of congestion and reduced tissue perfusion are documented in the setting of abnormal systolic and/or diastolic cardiac function.41, 42, 43 Making a diagnosis of HF can be difficult because the cardinal triad of edema, fatigue, and dyspnea are neither sensitive nor specific manifestations and atypical presentations should be recognized particularly when evaluating women, obese patients, and the elderly.41, 42, 43 A history and physical
Acknowledgements
The present consensus conference was supported by the CCS. The authors are indebted to Marie-Josée Martin and Mirela Lukac for logistic and administrative support.
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The disclosure information of the authors and reviewers is available from the CCS on the following websites: www.ccs.ca and/or www.ccsguidelineprograms.ca.
This statement was developed following a thorough consideration of medical literature and the best available evidence and clinical experience. It represents the consensus of a Canadian panel comprised of multidisciplinary experts on this topic with a mandate to formulate disease-specific recommendations. These recommendations are aimed to provide a reasonable and practical approach to care for specialists and allied health professionals obliged with the duty of bestowing optimal care to patients and families, and can be subject to change as scientific knowledge and technology advance and as practice patterns evolve. The statement is not intended to be a substitute for physicians using their individual judgment in managing clinical care in consultation with the patient, with appropriate regard to all the individual circumstances of the patient, diagnostic and treatment options available and available resources. Adherence to these recommendations will not necessarily produce successful outcomes in every case.