Cor Vasa 2008, 50(5):216-222 | DOI: 10.33678/cor.2008.070

Diagnosing chronic heart failure

Jaromír Hradec

III. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

Chronic heart failure (CHF) is one of the few cardiovascular pathological conditions whose prevalence and incidence in the population is on the rise. To explain, the incidence of CHF increases markedly with age, which is increasing quite rapidly in developed nations. In addition, management of acute cardiovascular disease is increasingly successful, with people no longer dying of it, but frequently surviving with myocardial injury, thus becoming candidates for developing CHF. Some experts even refer to an epidemiology of the 21st century.
Heart failure may develop secondary to either systolic or diastolic left ventricular dysfunction. The diagnosis of CHF is based on the presence of complaints (most often exertional dyspnea) and physical signs (e.g., peripheral edema, tachycardia, venostatic crepitations, etc.). However, as their specificity is very low, objective evidence of systolic or diastolic left ventricular dysfunction is also required. The techniques employed for this purpose most often in clinical practice include echocardiography combined with Doppler imaging. Chest x-ray is a useful procedure in the diagnosis of CHF, as it furnishes information about the shape and size of the heart and its individual chambers and, possibly, the presence of lung venostasis. The other methods of examination serve as only adjunct ones. The diagnosis of CHF has been largely improved by determination of the plasma levels of natriuretic peptides (BNP or NT-proBNP). It is particularly their negative predictive value which is high.

Keywords: Chronic heart failure; Diagnosis; Echocardiography; Doppler imaging; Chest x-ray; Natriuretic peptides

Published: May 1, 2008  Show citation