Archive for August, 2007

Diagnosis and Risk Stratification of Acute Heart Failure Syndromes

Diagnosis and Risk Stratification of Acute Heart Failure SyndromesAs you all well know, emergency physicians man the front line when patients present with any acute illness. Heart failure is no exception. With an expected ten million individuals with heart failure by the end of this year, we must be able to accurately and efficiently diagnose and treat this high morbidity condition. Just as important, it is our responsibility to be cognizant of the new research, new language, and treatment progress in the subject. For instance, the catchall words of “heart failure” can no longer be used to refer to any patient. Terms such as “diastolic heart failure” and “acute heart failure syndrome” have specific definitions and are replacing some of the older, less specific nomenclature. Perhaps the most significant contribution to AHFS diagnosis is the testing of natriuretic peptides. (NT)-proBNP and BNP both can be measured in the blood, but each has unique characteristics and differences. Knowledge of these attributes is critical to the diagnosis of AHFS. The interpretation of specific values in varied clinical settings hinges on your knowledge of the platform and its strengths and limitations. Future directions for heart failure diagnosis include the detection of sub-clinically apparent heart sounds, measurement of cardiothoracic width, new models for risk stratification, and heart failure observation units.  Join Dr. Alan Storrow as he presents the current and future management of heart failure in the emergency setting.

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