Emergency Medicine Cases Ep 197 Acute Heart Failure Risk Stratification and Disposition
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Aug 19, 2024 Discover the complexities of diagnosing acute heart failure and the over-admission of low-risk patients. Learn about critical symptoms, the implications of troponin levels, and the role of BNP in effective diagnosis. The podcast dives into various risk stratification tools, including the eMERGE score and Framingham criteria, enhancing management strategies. Explore how Point-of-Care Ultrasound is revolutionizing patient assessment and outcomes, emphasizing collaboration among emergency and cardiology departments for better care.
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Heart Failure Diagnosis Accuracy
- ED physicians are only 80% accurate when diagnosing acute heart failure.
- 30-day mortality and readmission rates for acute heart failure have not improved in decades.
Diagnostic Accuracy of Symptoms and Signs
- No single symptom or sign perfectly diagnoses acute heart failure.
- PND, orthopnea, S3, and JVD are relatively specific but challenging to assess.
Outcomes of Discharged Heart Failure Patients
- Roughly 10% of heart failure patients discharged from the ED return within two weeks for admission.
- Discharged heart failure patients face a concerning 4% mortality rate at 30 days and 23% at one year.