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Heart Failure: Difference between revisions
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A standard blood assessment covers a complete blood count, electrolytes, renal function, glucose and liver function. Furthermore, a urinalysis and other tests depending on the clinical condition complete the laboratory assessment. For example, cardiac troponins must be sampled if an ACS is in the differential diagnosis. In patients suspected of HF, values of natriuretic peptides (such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP)) can provide important information regarding diagnosis, management and prognosis of HF. Natriuretic peptides are enzymes, secreted by the atria or ventricles in response to myocardial wall stress. The most commonly used tests are the BNP and NT-proBNP measurements, which despite their different half-lifes in plasma, do not really differ in diagnostic ability. Cut-off values are different in acute settings with acute dyspnea than in chronic settings. Normal values are almost 100% specific, and exclude heart failure in patients > 18 year old. Abnormal values do not have a 100% predictive value, and objective evidence for heart failure is still needed. The values of BNP and NTproBNP are also used for evaluating prognosis in patients with known HF, in which higher values carry a worse prognosis. | A standard blood assessment covers a complete blood count, electrolytes, renal function, glucose and liver function. Furthermore, a urinalysis and other tests depending on the clinical condition complete the laboratory assessment. For example, cardiac troponins must be sampled if an ACS is in the differential diagnosis. In patients suspected of HF, values of natriuretic peptides (such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP)) can provide important information regarding diagnosis, management and prognosis of HF. Natriuretic peptides are enzymes, secreted by the atria or ventricles in response to myocardial wall stress. The most commonly used tests are the BNP and NT-proBNP measurements, which despite their different half-lifes in plasma, do not really differ in diagnostic ability. Cut-off values are different in acute settings with acute dyspnea than in chronic settings. Normal values are almost 100% specific, and exclude heart failure in patients > 18 year old. Abnormal values do not have a 100% predictive value, and objective evidence for heart failure is still needed. The values of BNP and NTproBNP are also used for evaluating prognosis in patients with known HF, in which higher values carry a worse prognosis. | ||
[[Image: | [[Image:suspected_heart_failure.svg|thumb|400px|Figure 4 flowchart suspected heart failure <cite>3</cite>]] | ||
===Exercise test=== | ===Exercise test=== | ||