Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool

Heart failure

Calculated pretest probability: 3.6 %
Relevant inclusion criteria: Age > 66 


1Myocardial infarction in history

Clinical signs

3Valsalva's maneuver
5Systolic murmur
6Edema lower extremities

To further investigations

Sources used:

1.Wang CS et al. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005 Oct 19;294(15):1944-56
2.Morgan S et al. Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey. BMJ. 1999 Feb 6; 318(7180): 368–372
3.Shamsham S et al. Essentials of the Diagnosis of Heart Failure. Am Fam Physician. 2000 Mar 1;61(5):1319-1328
4.Maisel AS et al. Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure. N Engl J Med 2002; 347:161-167
5.Kennedy S et al. Ability of physicians to diagnose congestive heart failure based on chest X-ray. J Emerg Med. 2011 Jan;40(1):47-52
6.Taylor C et al. Diagnosing Heart Failure – Experience and ‘Best Pathways’. European Cardiology - Volume 6 Issue 3;2010:6(3):10-12
7.Danielsen R et al. Prevalence of heart failure in the elderly and future projections: the AGES-Reykjavík study. Scand Cardiovasc J. 2017 Aug;51(4):183-189