Andersen et al reported an algorithm for evaluating the left ventricular filling pressure based on echocardiography. This can be used to evaluate a patient with dyspnea. The authors are from Oslo University Hospital, McMaster University, Methodist DeBakey Heart and Vascular Center, Massachusetts General Hospital, Cleveland Clinic and Yonsei University.
Method: echocardiography
Patient selection: dyspnea
Parameters:
(1) clinical and 2D echo findings
(2) diastolic dysfunction
(3) LAP (LVFP) as determined by the algorithm
Clinical and 2D Echo Findings
Diastolic Dysfunction
LAP (LVFP)
Action
normal
yes
elevated
possible CHF
indeterminate
consider invasive study
normal
diastolic stress test
normal
no
NA
consider non-cardiac cause
abnormal
NA
elevated
CHF
indeterminate
consider invasive study
normal
diastolic stress test if suspect cardiac etiology
where:
• The diastolic stress test may be noninvasive or invasive.
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