Features Useful in Diagnosing Heart Failure in Adult Emergency Department Patients With Dyspnea

• Historical Features
• Heart failure
• Myocardial infarction
• Coronary artery disease
• Symptoms
• Paroxysmal nocturnal dyspnea
• Orthopnea
• Dyspnea on exertion
• Physical Examination
• Listening for a third heart sound (ventricular filling gallop)
• Jugular venous pressure assessment
• Auscultating for rales and wheezing (wheezing decreases likelihood of CHF)
  
• Auscultating for a murmur
• Assessing the legs for edema
• Chest Radiograph
• Pulmonary venous congestion
• Interstitial edema
• Cardiomegaly
• Pleural effusion(s)
• Electrocardiogram Findings
• Atrial fibrillation
• Any abnormal result
• B-type Natriuretic Peptide
• Most useful when less than 400 pg/mL for decreasing the likelihood of heart failure
• Clinician’s Overall Assessment