Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions


Answer 1
  1. The most useful diagnostic test for evaluating CHF is 2-D echocardiography with Doppler flow studies. Echocardiography with Doppler study in patients with CHF helps to determine if the primary abnormality is pericardial, myocardial, or valvular and measures left ventricular ejection fraction to differentiate systolic from diastolic dysfunction. Neurohormones play a major role in the remodeling and progression of heart failure; they include norepinephrine, renin-angiotensin-aldosterone system, atrial natriuretic peptide, endothelin, antidiuretic hormone, interleukin-6, and tumor necrosis factor alpha. The most common cause of CHF today is coronary artery disease, accounting for two thirds of cases. The New York Heart Association classification is a functional status classification based on symptoms and does not correlate with ejection fraction. Although dyspnea is most commonly a symptom in systolic dysfunction, dyspnea from acute pulmonary edema can be a feature of diastolic dysfunction; thus, presentation alone does not help to differentiate the two.

     Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Am J Cardiol 1999;83:1A-38A.

    2. Gomberg-Maitland M, Baran DA, Fuster V. Treatment of congestive heart failure: guidelines for the primary care physician and the heart failure specialist. Arch Intern Med 2001;161:342-52.

    3. Heart failure. In: Arky RA, Kettyle WM, Hatem CJ, editors. MKSAP 12: Cardiovascular medicine. Philadelphia: American College of Physicians - American Society of Internal Medicine; 2001:38-49.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj