Heart failure

1. HEART FAILURE Diagnosis

2.  LAB INVESTIGATIONS
 cbc,rbs,RFT,LFT,serum
electrolytes,calcium,magnesium,lipid profile,Thyroid
profile
 BNP and NT-proBNP-inresponse to
stretch,overload,increased filling pressure<100 good
negative predictive value>400 consistent with Heart
failure
 Age specific cut points
 <50yrs - 450pg/ml
 50-75yrs - 900 pg/ml
 >75 yrs- 1800 pg/ml


3. Highly sensitive troponin -Acute Heart failure
with acute MI
Additional lab testing.
Hepatitis status,Hiv
status,hemochromotosis,ANA,ANCA,serum
protein electrophoresis,urine protein
electrophoresis,serum catecholamines

4. ECG findings
ST-T abnormalities ,increase voltage,Q
waves,PR intervals,QRS duration,RR
intervals,presencevofvP waves,arrhythmias
chest X ray
pulmonary edema,cardiomegaly
interstitial edema- highly specific to indendify
acute heart failur

5. ECHO Cardiography
Asses ventricular function,valvular
function,chamber size
and to exclude tamponade
Radionucleotide ventriculography(MUGA scan)
Cardiac Catheterization with ventriculography
coronary Angiogram with ventriculography
cardiac MRI
Endomyocardial biopsy