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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Heart Failure
Robert G. Badgett, Catherine R. Lucey, Najib Ayas, Sheri Keitz
Clinical Scenario


Topics Discussed: congestive heart failure, heart failure, left ventricular area fractional change, ventricular dysfunction, left

Excerpt: "A 68-year-old patient with a history of smoking, dyslipidemia, and claudication presents for a follow-up appointment. He has no cardiac symptoms. Although he has no history of a myocardial infarction, he has anterior Q waves on an electrocardiogram (ECG). You believe him to be at high risk for asymptomatic left ventricular dysfunction and that a change in his medications might decrease the risk for symptomatic heart failure. Does he have a reduced ejection fraction?..."
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