Criteria for Distinguishing Acute Heart Failure from COPD or Asthma in Dyspneic Patient

Purpose: To evaluate a patient with dyspnea in a prehospital setting using the criteria of Prosen et al.

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Evaluation

Are you evaluating a patient with dyspnea in a prehospital setting?

Yes

Modified Boston score for heart failure

from 0 to 12

Serum pro-NT-BNP in

pg/mL

Number of comet signs seen in

Left anterior upper lung zone

comet signs

Left anterior lower lung zone

comet signs

Left lateral upper lung zone

comet signs

Left lateral lower lung zone

comet signs

Right anterior upper lung zone

comet signs

Right anterior lower lung zone

comet signs

Right lateral upper lung zone

comet signs

Right lateral lower lung zone

comet signs

Results

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Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Number of left-sided lung zones positive

Number of right-sided lung zones positive

Is there evidence of heart failure on ultrasonography?

Number of parameters suggesting heart failure

Does the patient have evidence of heart failure?

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Risk Factors
Clinical Diagnosis, Including Family History For Genetics
Imaging Studies
Laboratory Tests
Other Testing
Criteria For Diagnosis
Severity, Prognosis, Stage
Complications
Differential Diagnosis And Mimics, Red Flags
- High-Output Heart Failure Associated with Arteriovenous Fistula, Hemangioma or Other Vascular Malformation
Failure Handling, When To Refer
- Indications for Referral of Patient with Heart Failure to Cardiologist
- Recommended Triage Times for Patient with Heart Failure

Therapy

Options
- Treatment Outcome - B-Type Natriuretic Peptide - (BNP) and Severe Congestive Heart Failure (CHF)
Selection
Failure Handling And Therapy Escalation
Prevention
- Predicting Risk of Heart Failure in Framingham Study
- Two Minute Assessment of Hemodynamic Profile for Patient with Possible Heart Failure

Monitoring

Response To Therapy
Drug Levels
- Boston Criteria for Diagnosis Congestive Heart Failure
Complication Detection
Comorbid Conditions

Patient Concerns

Disability And Performance
- Cognitive Dysfunction in Heart Failure
Quality Of Life
- Cognitive Dysfunction in Heart Failure
- Discharge Criteria for Patient Hospitalized for Heart Failure
End-of-life, Palliative Care
- Criteria for Inotrope Dependence | Refractory End-Stage Heart Failure
- Prognostic Factors for Ambulatory Patient w/ Chronic Congestive Heart Failure

Specialty

Cardiology

Objective

imaging studies
laboratory tests
differential diagnosis and mimics
red flags

ICD-10

I50 - Heart failure
J44.9 - Chronic obstructive pulmonary disease, unspecified
J45 - Asthma
R06.0 - Dyspnoea

Info

Purpose: To evaluate a patient with dyspnea in a prehospital setting using the criteria of Prosen et al.

Specialty: Cardiology

Objective: imaging studies, laboratory tests, differential diagnosis and mimics, red flags

ICD-10: I50, J44.9, J45, R06.0,

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