Challenges in Diagnosing Acute Heart Failure

Diagnosing acute heart failure poses significant challenges, as emergency department (ED) physicians demonstrate only about 80% accuracy in making this diagnosis. A lack of definitive clinical features complicates the identification of heart failure, as none of the symptoms or signs provide perfect sensitivity or specificity. For instance, findings like paroxysmal nocturnal dyspnea and orthopnea hold some specificity, yet many physicians struggle to accurately assess less clear signs such as an S3 heart sound. The variety of heart failure types, including diastolic and systolic, adds to the intricacies of determining whether a patient should be admitted or sent home.