The Rational Clinical Examination
David L. Simel, Drummond Rennie
Heart Failure
Robert G. Badgett, Cynthia D. Mulrow, Catherine R. Lucey
How to Detect Increased Left Ventricular Filling Pressure
Topics Discussed:
congestive heart failure, diagnostic process, ejection fraction, heart failure, heart failure, diastolic, summarizing the evidence, systolic dysfunction
Excerpt:
"Although clinicians routinely assess filling pressure in patients
similar to those in cases 2 and 3, there is little literature on
our ability to do so. Four studies
12-15 assess
whether multiple clinical findings identify patients with invasively determined
increased left ventricular filling pressure. Three of these studies13-15 involve
patients with known severe systolic dysfunction (mean EF < 20%)
who are referred for pretransplant evaluation (Table
16-1). These studies are biased by a high prevalence of increased
filling pressure...."
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