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Congestive heart failure

Prevalence
Causes
Clinical features
Differential diagnosis
Investigations
Therapy
Prevention
Prognosis
Investigations
  • chest X-ray b looking for: b
    • cardiomegaly
    • interstitial oedema
    • inverted pulmonary blood-flow distribution
Why?

Cardiomegaly, interstitial oedema and venous congestion make heart failure slightly more likely

Patient b Target Disorder and
Reference Standard
Diagnostic Test LR+
(95% CI)
Post-test Probability LR-
(95% CI)
Post-test Probability
dypsnoea and suspected left ventricular dysfunction b
(pre-test probability: 31%)
increased preload
(?echocardiogram)
cardiomegaly 4
64% 0.7
24%
    redistribution/ congestion 2
47% 0.52
19%
    interstitial oedema 2
47% 0.7
22%
  decreased ejection fraction
(?echocardiogram)
cardiomegaly 2.4
52% 0.62
21%
    redistribution/ congestion 3
57% 0.6
21%
    interstitial oedema 4
64% 0.9
29%
 

 

Expiry date: June 2003
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   B   Lee
CAT Writers   CM   Ball , CJ   Wotton , A   Yates