Clinical features
The clinical features of heart failure include symptoms such as:
- most common symptoms are:
- breathlessness
- exertional
- at rest - can be orthopnoea and paroxysmal nocturnal dyspnoea (PND)
- fatigue
- exercise intolerance
- fluid retention - ankle swelling
- other non specific symptoms include:
- nocturia
- anorexia
- abdominal bloating and discomfort
- constipation,
- cerebral symptoms - confusion, dizziness and memory impairment (1)
signs such as:
- tachycardia
- displaced apex beat
- third heart sound
- gallop rhythm
- reduced pulse volume
- pulsus alternans
- raised JVP –
- in right heart failure
- has a high predictive value in the diagnosis
- but is often absent
- oedema
- rales, or basal crepitations
- hepatomegaly
- ascites (2)
Reference:
- (1) National Institute for Health and Clinical Excellence (NICE) 2010. Chronic heart failure. National clinical guideline for diagnosis and management in primary and secondary care
- (2) European Society of Cardiology (ESC) 2008. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008
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