Chronic heart failure

Symptoms

• Dyspnea.
• Orthopnea.
• Fatigue.
• Nocturnal dyspnea.
• Anorexia.
• Weight gain.

Signs

• Peripherals oedema.
• Tachycardia.
• S3.
• Elevated jugular pressure.
• Pleural effusion.
• Rales or crackles.

Etiology and work up

• ECG
• Chest X-ray.
• Echocardiography._
• Blood test (CBC, Na, K, BNP, urea, creatinin, AST, ALT, γGT, troponin, blood sugar) In heart failure BNP is usually > 400 pg/ml. If < 100 pg/ml, consider other diagnosis.
• Non invasive test to detect ischemia, coronarography.
• Arrhythmia detection (ECG, Holter, ET)
• Drugs or alcool consumption.
• Medication (chemiotherapy, antidepressive drugs, phenothiazin, anti TNF).
• Infectious tests (VIH, Lyme disease, Coxsackie, Chagas, jellyfish, snakes, scorpions).

Treatment