Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]; Seyedmahdi Pahlavani, M.D. [3]; Tarek Nafee, M.D. [4]; Edzel Lorraine Co, DMD, MD[5] Overview[edit]Once the diagnosis of heart failure is made, subsequent laboratory studies should be directed toward the identification of an underlying cause of heart failure. Laboratory Tests[edit]Renal Function[edit]Renal function should be assessed as a rough guide to the patient's intravascular volume status and renal perfusion. A urinalysis is helpful in the assessment of the patient's volume status. Electrolyte assessment and the correction of electrolyte disturbances such as hypokalemia, hyperkalemia and hypomagnesemia is critical in those patients treated with diuretics. Hyponatremia (due to poor stimulation of the baroreceptors and appropriate ADH release and free water retention) is associated with a poor prognosis. Hematologic Studies[edit]A complete blood count should be obtained to assess for the presence of anemia which may exacerbate heart failure and to assess the patients coagulation status which may be impaired due to hepatic congestion. Thyroid Studies[edit]The assessment of thyroid function tests is particularly important in the patient who is being treated with concomitant therapy with an agent such as amiodarone. Biomarkers[edit]Biomarkers are going to play a great role in diagnosis of heart failure. Natriuretic Peptides: BNP or NT-proBNP[edit]
The CoDE-HF decision support tool may help diagnose heart failure[2]. The CoDE-HF interprets the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in various settings including obesity.
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Biomarkers indications for use[edit]Abbreviations: ACC: American College of Cardiology, AHA: American Heart Association, ADHF: acute decompensated heart failure, BNP: B-type
natriuretic peptide, COR: Class of Recommendation, ED: emergency department, HF: heart failure, NT-proBNP: N-terminal pro-B-type natriuretic peptide, NYHA: New York Heart Association, pts: patients (*)Other biomarkers of injury or fibrosis include soluble ST2 receptor, galectin-3, and high-sensitivity troponin. Biomarkers of Myocardial Injury: Cardiac Troponin T or I[edit]Even without obvious myocardial ischemic injury, troponin level may be increased in heart failure which means undergoing myocyte injury.[12] Elevated levels of troponin is associated with impaired hemodynamics, progressive LV dysfunction and increased mortality rates.[13] Carbohydrate Antigen 125[edit]CA-125 is an emerging, highly sensitive biomarker for heart failure.[14] Although it is not yet used in clinical practice, the CHANCE-HF trial has demonstrated utility in using CA-125 to guide diuretic therapy and for determining short-term prognosis.[15] CA-125 is a non-specific antigen that is most strongly associated with ovarian cancer. In patients with acute heart failure, ambulatory follow-up care aimed at titrating diuretic use according to CA-125 levels has demonstrated ~50% reduction in rehospitalizations.[15] CA-125 was first associated with heart failure in 1999 by Nagele et al.[14][16] Initial lab tests for evaluation of HFrEF[edit]
2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [17][edit]Initial Laboratory and Electrocardiographic Testing (DO NOT EDIT) [17][edit]
Use of Biomarkers for Prevention, Initial Diagnosis, and Risk Stratification (DO NOT EDIT) [17][edit]External Links[edit]
References[edit]
Template:WikiDoc Sources What labs do you see for heart failure?A thorough laboratory workup including a CBC and urinalysis, as well as electrolyte, blood urea nitrogen (BUN), creatinine, glucose, hemoglobin A1c, liver enzyme, lipid, and thyroid function tests is recommended to evaluate for risk factors and comorbidities in HF.
What indicates leftLeft-sided Heart Failure Symptoms
Shortness of breath. Difficulty breathing when lying down. Weight gain with swelling in the feet, legs, ankles. Fluid collection in the abdomen.
Which assessment finding is an indication of leftOn physical exam, the most common signs encountered are: Rales on lung auscultation indicative of pulmonary edema. Decreased breath sounds on lung auscultation suggestive of pleural effusion. S3 gallop on heart auscultation indicative of elevated left ventricular end-diastolic pressure.
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