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Diagnosis and Diagnostic Tools

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Steps in the diagnosis of congestive heart failure:

  1. Take a proper clinical history. Emphasis should be placed on determining if the patient has experienced any of the cardinal symptoms of heart failure, such as dyspnea and fatigue. Ensure that you ask about the symptoms which the patient may not automatically associate with cardiac problems, such as abdominal pain, or confusion.

  2. As you have learned, certain predictors of heart failure, such as hypertension or diabetes are more significant in women than in men. Take this gender specific information into account when considering your diagnosis.

  3. Recognize that women often explain their symptoms with more ambiguity and diversity than men do.  This could impede the diagnostic process. [1][2]

  4. Consider their lifestyle.  Do they smoke? Drink? Do they get regular exercise? What are their job demands?

  5. Perform a physical examination, searching for the clinical signs of heart failure that will be detailed in the following pages.

  6. Order the appropriate diagnostic tests, some of which will be outlined on the next page.

 

Activity: Diagnostic Tests

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1. Ekman I, Ehrenberg A. Fatigue in chronic heart failure, does gender make a difference? Eur J Cardiovasc Nurs 2003;1:77– 82.

2. Stromberg A, Martensson J. Gender differences in patients with heart failure. Eur J Cardiovasc Nurs 2003;2:7? 18.

All references for this section