Heart Failure

Heart failure is a widespread disease that accounts for more than one million hospitalizations annually in the United States, and nearly half a million new cases arise each year. Heart failure is a syndrome diagnosed by clinical signs and symptoms demonstrating a reduction in cardiac function. Prompt diagnosis and management from the emergency department (ED) is an important benchmark in the care of heart failure patients, as 80% of all hospitalizations due to heart failure are through the ED and inpatient mortality ranges from anywhere from 4% up to 25%. This chapter focuses on the utility of the history and physical exam, natriuretic peptides, chest radiography, and lung ultrasound in the diagnosis of acute heart failure in the ED. Chest X-ray (CXR) findings that raise concern for heart failure include pulmonary edema, cardiomegaly, and pleural effusion. Other conditions have similar CXR findings.