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Diagnosis
Review: medical history, physical examination, and routine tests are useful for diagnosing heart failure in dyspnoea

http://dx.doi.org/10.1136/ebm.11.2.58

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    Wang CS, FitzGerald JM, Schulzer M, et al. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA 2005;294:1944–56.
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 Q In patients presenting to the emergency department (ED) with dyspnoea, how useful are medical history, physical examination, and readily available tests in diagnosing heart failure (HF)?

    Clinical impact ratings Internal medicine ★★★★★★★ IM/Ambulatory care ★★★★★★★ GP/FP/Primary care ★★★★★★☆ Emergency medicine ★★★★★★☆ Cardiology ★★★★★☆☆

    METHODS

    Embedded ImageData sources

    Medline (1966 to July 2005) and reference lists of relevant articles and textbooks.

    Embedded ImageStudy selection and assessment

    English language studies that assessed the diagnostic accuracy of elements of the history, physical examination, or readily available tests in adults with undifferentiated dyspnoea presenting to the ED. The reference standard was diagnosis by a panel of physicians based on clinical signs and symptoms and an appropriate measure of cardiac dysfunction. 2 reviewers independently assessed the studies for inclusion and methodological quality.

    Embedded ImageOutcomes

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    Footnotes

    • For correspondence: Dr N T Ayas, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada. najib.ayas{at}vch.ca

    • Source of funding: no external funding.