Congestive heart failure differential diagnosis

Congestive heart failure Microchapters
Home
Patient Information
Overview
Classification
Pathophysiology
Causes
Differentiating Congestive heart failure from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Clinical Assessment
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
Cardiac MRI
Echocardiography
Exercise Stress Test
Myocardial Viability Studies
Cardiac Catheterization
Endomyocardial biopsy
Treatment
Invasive Hemodynamic Monitoring
Medical Therapy: Acute Pharmacotherapy Chronic Pharmacotherapy: Diuretics ACE Inhibitors Angiotensin receptor blockers Aldosterone Antagonists Beta Blockers Ca Channel Blockers Nitrates Hydralazine Positive Inotropics Anticoagulants Antiarrhythmic Drugs Nutritional Supplements Omega-3-Fatty Acid Hormonal Therapies Drugs to Avoid Drug Interactions Treatment of underlying causes Associated conditions
Exercise Training
Surgical Therapy: Biventricular Pacing or Cardiac Resynchronization Therapy (CRT) Implantation of Intracardiac Defibrillator Ultrafiltration Cardiac Surgery Left Ventricular Assist Devices (LVADs) Cardiac Transplantation
ACC/AHA Guideline Recommendations: Hospitalized Patients Patients With a Prior MI Sudden Cardiac Death Prevention Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D)
Implementation of Practice Guidelines
Congestive heart failure end-of-life considerations
Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF
Congestive heart failure differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Congestive heart failure differential diagnosis
CDC on Congestive heart failure differential diagnosis
Congestive heart failure differential diagnosis in the news
Blogs on Congestive heart failure differential diagnosis</small>
Directions to Hospitals Treating Congestive heart failure differential diagnosis
Risk calculators and risk factors for Congestive heart failure differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Congestive heart failure should be distinguished from other conditions that cause dyspnea, fatigue and edema.

Differentiating Congestive Heart Failure from other Diseases

Heart failure is a clinical syndrome of dyspnea, fatigue and edema. There are several disorders that cause heart failure and should not be confused with the syndrome of heart failure.

• Cardiac arrest and asystole refer to situations in which there is no cardiac output at all. Without urgent treatment these result in sudden death.
• Myocardial infarction ("Heart attack") refers to heart muscle damage due to an insufficient blood supply to the heart, usually as a result of a blocked coronary artery.
• Cardiomyopathy refers specifically to problems within the heart muscle, and these problems can result in heart failure. Ischemic cardiomyopathy implies that the cause of muscle damage is coronary artery disease. Dilated cardiomyopathy implies that the muscle damage has resulted in enlargement of the heart. Hypertrophic cardiomyopathy involves enlargement and thickening of the heart muscle.

Other Causes of Dyspnea

There are non-cardiac causes of edema that primarily involve the lung or respiratory system. These conditions are distinguished from heart failure in so far as they do not cause peripheral edema, and they are not be associated with an elevation in BNP.

Other Conditions that Cause Dyspnea that are Emergencies

The following emergency conditions should be excluded when diagnosing a patient with heart failure:

• Asthma or bronchospasm
• Foreign body aspiration
• H. influenza epiglottitis
• Spontaneous pneumothorax

Non Cardiac Causes of Dyspnea

• Abdominal masses
• Acute bronchitis
• Acute Chest Syndrome
• Acute myeloid leukemia
• Acute promyelocytic leukemia
• Acute tracheobronchitis
• AIDS
• Air pollution
• Air-conditioner lung
• Allergy
• Alpha 1-antitrypsin deficiency
• Altitude sickness
• Amniotic fluid embolism
• Amphotericin B
• Amyl nitrite
• Amyotrophic Lateral Sclerosis (ALS)
• Anaphylactoid reactions
• Anaphylaxis
• Anemia
• Anthrax
• Anxiety
• Asbestosis
• Aspergillus clavatus
• Aspiration
• Asthma
• Atelectasis
• Atypical pneumonia
• Barium
• Beta-blockers
• Betazole
• Bird breeder's lung
• Bird fancier's lung
• Bland-White-Garland Syndrome
• Bleomycin in ABVD
• Blood transfusion
• Brain stem infarction
• Bronchial asthma
• Bronchial tumors
• Bronchiolitis
• Bronchiolitis obliterans
• Bronchiolitis obliterans organizing pneumonia
• Bronchitis
• Bronchogenic carcinoma
• Bronchoscopy
• Caspofungin
• Cheese worker's lung
• Chemical worker's lung
• Chest trauma
• Chest tube
• Cholesterol pericarditis
• Chronic bronchitis
• Chronic fatigue syndrome
• Chronic Obstructive Pulmonary Disease (COPD)
• Chylothorax
• Cirrhosis
• Cladosporium
• CMV Pneumonitis
• Community-acquired pneumonia
• Croup
• Cystic Fibrosis
• Daptomycin
• Decompression sickness
• Decreased thoracic or diaphragmatic excursion
• Diabetic coma
• Diffuse panbronchiolitis
• Diverticulosis
• Drugs
• Ehrlichiosis (canine)
• Empty nose syndrome
• Empyema, pleural
• Encephalitis
• Eosinophilic pneumonia
• Ephedrine
• Epidemic dropsy
• Erdheim-Chester disease
• Esophageal cancer
• Esophageal diseases with tracheal compression
• Exercise-induced asthma
• Extrinsic allergic alveolitis
• Fat embolism
• Fibrosing alveolitis, cryptogenic
• Gamma-Hydroxybutyric acid
• Gastroesophageal reflux
• Gemeprost
• Glatiramer acetate
• Glottal edema
• Goiter
• Goodpasture syndrome
• Grain handler's lung
• Gram-negative sepsis
• Guillain-Barre Syndrome
• Hemochlyothorax
• Hemothorax
• Histiocytosis X
• Hoose (disease)
• Humidifier lung
• Hydrochlyothorax
• Hypersensitivity Pneumonitis
• Hyperthyroidism
• Hypoxia
• Hysteria
• Idiopathic pulmonary fibrosis
• Iloprost
• Interstitial lung disease
• Intoxication (carbon monoxide, cyanide)
• Intrapulmonary receptor stimulation
• Intussusception (medical disorder)
• Iron deficiency anemia
• Irregular Heart Rhythms
• Ketorolac
• Kyphoscoliosis
• Laryngeal/bronchospasm
• Leukemia
• Lung cancer
• Lymphangitic metastases
• Lymphocytic interstitial pneumonia
• Lymphoma
• Malignant Mesothelioma
• Malt worker's lung
• Mediastinal tumors
• Megaloblastic Anemias
• Mercury (element)
• Metabolic acidosis
• Methyl isocyanate
• Micropolyspora faeni
• Miliary tuberculosis
• Mollusk shell hypersensitivity
• Mucor stolonifer
• Multiple rib fractures
• Myasthenia Gravis
• Myxoma
• Neuromuscular disease
• Obesity
• Phrenic nerve paralysis
• Pleural callosity
• Pneumoconiosis
• Pneumonia
• Pneumochlyothorax
• Pneumothorax
• Pleural Effusion
• Pleural fibrosis
• Polyradiculitis
• Pulmonary arteriovenous malformation
• Pulmonary Emphysema
• Pulmonary fibrosis
• Quincke's Edema
• Radiation pneumonitis
• Respiratory tract infection
• Sarcoidosis
• Shock
• Shock lung
• Sleep Apnea Syndrome
• Trauma
• Tracheal stenosis
• Tracheal tumors
• Tracheomalacia
• Tracheobronchial collapse
• Uremia

Other Causes of Fatigue

There are numerous non-cardiac causes of fatigue. Again, these non-cardiac causes are not associated with dyspnea and edema.

Other Causes of Edema

Other non cardiac causes of pedal edema are listed below. Obviously, the majority of these disorders do not also cause dyspnea and fatigue, and that distinguishes them form heart failure.

• ACE inhibitor
• Aceon
• Acquired C1-esterase inhibitor deficiency
• Actos
• Acute glomerulonephritis
• Addison's Disease
• Aldomet
• Amlodipine
• Amniotic band
• Angioneurotic edema
• Angiotensin converting enzyme inhibitor
• Anemia
• Anorexia Nervosa
• AV fistula
• Avandia
• Bartter's Syndrome
• Beta blockers
• Boils
• Bruise
• Bulimia Nervosa
• Burn
• Cachexia
• Carbuncle
• Cardura
• Cellulitis
• Chemotherapy
• Cisplatin
• Cold (physical stimuli)
• Contact dermatitis
• Contusion
• Cushing's Syndrome
• Diltiazem
• Drugs
• Docetax
• Erysipelas
• Exudative enteropathy
• Filariasis
• Fracture
• Frostbite
• Gas gangrene
• Glitazones
• Gout
• Hyperthyroidism
• Hypoalbuminemia
• Hypoplasia
• Hypothyroidism
• Ibuprophen
• Idiopathic edema
• Insect bite
• Irritant
• Ligamentous sprain
• Liver failure
• Lymph node mass
• Malabsorption
• Malnutrition
• Mediastinal cancer
• Milroy's Disease
• Minipress
• Motrin
• Musculoskeletal trauma
• Neoplasm
• Nephrotic Syndrome
• Nifedipine
• Norvasc
• Osteomyelitis
• Peripheral nerve lesion
• Premenstrual edema
• Scleroderma
• Sepsis syndrome
• Snakebites
• Starvation edema
• Sunburn
• Surgical excision
• Tendonous strain
• Thrombophlebitis
• Thrombosis
• Tight clothing
• Trentinion
• Trichinosis
• Tumors
• Univasc
• Valproic acid
• Varicose veins
• Vesinoid
• vytorin