Difficulties in the diagnosis of heart failure in patients with comorbidities

作者：Trullas J C^*; Casado J; Morales Rull J L

来源：Revista Clinica Espanola, 2016, 216(5): 276-285.

DOI：10.1016/j.rce.2015.10.001

• Heart failure
• Diagnosis
• Comorbidity
• Natriuretic peptides

Heart failure (HF) patients present frequently comorbidities and the diagnosis of HF Comorbidity; in this setting is a challenge. The symptoms and signs of HF may be atypical and can be simulated Natriuretic peptides or disguised by co-morbidities such as respiratory disease and/or obesity. For this reasons, confirmation of the diagnosis always requires further tests. Natriuretic peptides accurately exclude cardiac dysfunction as a cause of symptoms, but the optimal cut-off levels for ruling out and ruling in HF diagnosis are influenced by different co-morbidities. Echocardiography should be performed in all patients to confirm the diagnosis of HF, except in those cases with low clinical probability and a concentration of brain natriuretic peptides below the exclusion cut-off. This review aims to provide a practical clinical approach for the diagnosis of HF in patients with comorbidity, focusing in older patients and patients with chronic obstructive pulmonary disease and/or obesity.

• 出版日期2016-7