Evidence Base: Pulmonary

Accuracy in Congestive Heart Failure

Question: Does this patient have congestive heart failure?

This study prospectively evaluated physical examination findings in 52 patients with underlying chronic left ventricular dysfunction and compared those results to hemodynamic measurements on heart catheterization.

Examination

Definition: elevated capillary wedge pressure >18 mmHg

Examination	+Predictive Value	-Predictive Value	Sensitivity	Specificity
Rales (crackles)	100%	35%	0.24	1.00
S3 Gallop	86%	48%	0.68	0.73
Jugular Venous Distension	95%	47%	0.57	0.93
Chest X-Ray Vascular Redistribution	89%	48%	0.65	0.80
Interstitial Edema	83%	33%	0.27	0.87
Source: Butman, et al.

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