The incidence, ethiology and epidemyology of heart failure at admittance in emergency room

The incidence, ethiology and epidemyology of heart failure at admittance in emergency room

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Title: The incidence, ethiology and epidemyology of heart failure at admittance in emergency room
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Article_Title: The incidence, ethiology and epidemyology of heart failure at admittance in emergency room
Authors: Radu Jipa1, Maria Puschita1,2
Affiliation: 1 Emergency Unit, Emergency Clinical County Hospital, Arad, Romania
2 “Vasile Goldis” Western University, Faculty of Medicine, Pharmacy and Dental Medicine, Arad, Romania
Abstract: Heart failure is a very common cause of presenting at Emergency Room (E.R.). In this study I have tried to establish the most reliable diagnostic criteria of heart failure in E.R., based on clinical and paraclinical grounds. The study was made on a group of unselected patients, arrived with dyspnoea at E.R., and had the following objectives: establishing of the heart failure prevalence; establishing the common causes of decompensation; establishing the clinical and paraclinical parameters; finding the other diseases that can produce dyspnoea; establishing the most reliable diagnostic criteria. We found the most frequent causes of acute heart failure in our area and the fact that the most accurate diagnostic tool to diagnose this disease, have to include echocardiography. Also, we found that the clinical criteria discover the smallest number of really sick patients. To improve the quality of medical services and gain time in establishing the diagnosis and initialising the treatment, we need to use either echocardiography in our investigations (difficult because of the technical limitations and low level of patient’s cooperation), or the use new methods (like NTproBNP, subject of another clinical study).
Keywords: dyspnoea, heart failure, natriuretic peptides, NT pro-BNP
References: Nils Kucher, MD; Gert Printzen, MD; Tanja Doernhoefer, MD; et. al. Circulation, September 30, 2003, Volume 108, Issue 13
Januzzi JL, Camargo CA -N-terminal ProBNP for emergency evaluation for shortness of breathing ProBNP investigation of dyspnea in the Emergency Department (PRIDE) study. Am J Cardiol 2005; 95:948-954;
Christopher Heeschen, MD; Christian Wi. Hamm, MD; Veselin Mitrovic, MD; et. al., for the Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators Circulation. 2004;110:3206-3212;
Roberto Bassan, Alfredo Potsch, Alan Maisel, et. al.; European Heart Journal Advance Access originally published online on December 1, 2004;
Lok Bin Yap, MBBS; Dev Mukerjee, MD; Peter M. Timms, BSc et. al. Chest. 2004;126:1330-1336
L. Katherine Morrison, BS*, Alex Harrison, BS*, Padma Krishnaswamy, MD*, et. al. – J Am Coll Cardiol, 2002; 39:202-209;
Martina Brueckmann, MD*; Günter Huhle, MD*; Siegfried Lang, PhD; et. al. Circulation. 2005;112:527-534;
Alan Maisel, MD, Judd E. Hollander, MD, David Guss, MD, et. al. REDHOT Investigators J Am Coll Cardiol, 2004; 44:1328-1333;
Christian Mueller, M.D., André Scholer, Ph.D., Kirsten Laule-Kilian, B.Sc., et. al. New England Journal of Medicine, Volume 350:647-654;
Milton Packer, MD Circulation. 2003;108:2950
Read_full_article: pdf/vol12/iss3/JMA12-3-09Jipa.pdf
Correspondence: Radu Jipa, MD, Unitatea de primire a urgenţelor, Spital Clinic Judeţean de Urgență Arad
E-mail: r_jipa@yahoo.com

Read full article
Article Title: The incidence, ethiology and epidemyology of heart failure at admittance in emergency room
Authors: Radu Jipa1, Maria Puschita1,2
Affiliation: 1 Emergency Unit, Emergency Clinical County Hospital, Arad, Romania
2 “Vasile Goldis” Western University, Faculty of Medicine, Pharmacy and Dental Medicine, Arad, Romania
Abstract: Heart failure is a very common cause of presenting at Emergency Room (E.R.). In this study I have tried to establish the most reliable diagnostic criteria of heart failure in E.R., based on clinical and paraclinical grounds. The study was made on a group of unselected patients, arrived with dyspnoea at E.R., and had the following objectives: establishing of the heart failure prevalence; establishing the common causes of decompensation; establishing the clinical and paraclinical parameters; finding the other diseases that can produce dyspnoea; establishing the most reliable diagnostic criteria. We found the most frequent causes of acute heart failure in our area and the fact that the most accurate diagnostic tool to diagnose this disease, have to include echocardiography. Also, we found that the clinical criteria discover the smallest number of really sick patients. To improve the quality of medical services and gain time in establishing the diagnosis and initialising the treatment, we need to use either echocardiography in our investigations (difficult because of the technical limitations and low level of patient’s cooperation), or the use new methods (like NTproBNP, subject of another clinical study).
Keywords: dyspnoea, heart failure, natriuretic peptides, NT pro-BNP
References: Nils Kucher, MD; Gert Printzen, MD; Tanja Doernhoefer, MD; et. al. Circulation, September 30, 2003, Volume 108, Issue 13
Januzzi JL, Camargo CA -N-terminal ProBNP for emergency evaluation for shortness of breathing ProBNP investigation of dyspnea in the Emergency Department (PRIDE) study. Am J Cardiol 2005; 95:948-954;
Christopher Heeschen, MD; Christian Wi. Hamm, MD; Veselin Mitrovic, MD; et. al., for the Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators Circulation. 2004;110:3206-3212;
Roberto Bassan, Alfredo Potsch, Alan Maisel, et. al.; European Heart Journal Advance Access originally published online on December 1, 2004;
Lok Bin Yap, MBBS; Dev Mukerjee, MD; Peter M. Timms, BSc et. al. Chest. 2004;126:1330-1336
L. Katherine Morrison, BS*, Alex Harrison, BS*, Padma Krishnaswamy, MD*, et. al. – J Am Coll Cardiol, 2002; 39:202-209;
Martina Brueckmann, MD*; Günter Huhle, MD*; Siegfried Lang, PhD; et. al. Circulation. 2005;112:527-534;
Alan Maisel, MD, Judd E. Hollander, MD, David Guss, MD, et. al. REDHOT Investigators J Am Coll Cardiol, 2004; 44:1328-1333;
Christian Mueller, M.D., André Scholer, Ph.D., Kirsten Laule-Kilian, B.Sc., et. al. New England Journal of Medicine, Volume 350:647-654;
Milton Packer, MD Circulation. 2003;108:2950
*Correspondence: Radu Jipa, MD, Unitatea de primire a urgenţelor, Spital Clinic Judeţean de Urgență Arad
E-mail: r_jipa@yahoo.com