• Exercise intolerance

• Nocturia and/or polyuria

• Hemoptysis

• Abdominal pain

• Mental status changes

• Lethargy Signs

• Pulmonary rales

• Pulmonary edema

• Pleural effusion

• Cheyne-Stokes respiration

• Tachycardia

• Cardiomegaly

• Peripheral edema (e.g., pedal edema, which is swelling of feet and ankles)

• Jugular venous distention (JVD)

• Hepatojugular reflux (HJR)

• Hepatomegaly

• Cyanosis of the digits

• Pallor or cool extremities

Laboratory Tests

• BNP greater than 100 pg/mL (greater than 100 ng/L or 28.9 pmol/L) or N-terminal proBNP (NT-proBNP) greater than 300 pg/mL (greater than 300 ng/L or greater than 35.4 pmol/L)

• ECG: May be normal or could show numerous abnormalities including acute ST-T wave changes from myocardial ischemia, atrial fibrillation, bradycardia, and LV hypertrophy

• Serum creatinine: May be increased owing to hypoperfusion; pre-existing renal dysfunction can contribute to volume overload

• CBC: Useful to determine if HF is due to reduced oxygencarrying capacity

• CXR: Useful for detection of cardiac enlargement, pulmonary edema, and pleural effusions

• Echocardiogram: Used to assess LV size, valve function, pericardial effusion, wall motion abnormalities, and EF

BNP, B-type natriuretic peptide; CBC, complete blood cell count; CXR, chest x-ray; EF, ejection fraction;

LV, left ventricular.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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