Flashcards in Investigations Deck (6)
How do you diagnose heart failure as a syndrome?
Patients should have had:
- Symptoms typical of HF (SOB on exertion/rest, fatigue)
- Signs typical of HF (tachycardia, pulmonary/peripheral oedema, raised JVP)
- Objective evidence of structural or functional cardiac abnormality at rest (cardiomegaly, S3)
What bloods are used to investigate heart failure?
- Haematinics - anaemia, B12
- U+E - also CKD
- TFT - hypo/hyperthyroidism
- Glucose - diabetes
What is the main investigation for heart failure?
Brain natriuretic peptide (BNP)
- 32 amino acid polypeptide secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells
- Normal levels rule out HF
- Provides prognostic information
What other investigations can be used for heart failure?
- CXR - cardiac size, pulmonary oedema/pleural effusion
- ECG - diagnostic/therapeutic info - AF/arrhythmias, old AMI, LBBB, LVH (HTN, AS, HOCM)
What does echocardiography tell you in HF?
Echocardiography is a key investigation.
Provides info relating to ejection fraction of LV (normal approx 60%), patients divided into:
- HF with preserved LV function (EF >45%)
- HF with LV systolic dysfunction (EF < 45%)