• Exercise intolerance
• Nocturia and/or polyuria
• Abdominal pain
• Mental status changes
• Lethargy Signs
• Pulmonary rales
• Pulmonary edema
• Pleural effusion
• Cheyne-Stokes respiration
• Peripheral edema (e.g., pedal edema, which is swelling of feet and ankles)
• Jugular venous distention (JVD)
• Hepatojugular reflux (HJR)
• Cyanosis of the digits
• Pallor or cool extremities
• 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.
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