Q: All of the following are the clinical signs of acute decompensated congestive heart failure (CHF) - popularly known as exacerbation of CHF - except?
A) Elevated jugular venous pressure
B) Positive hepatojugular reflux test
C) A tender and enlarged liver
D) Pleural effusion, more frequent at left
E) Leg edema
Answer: D
In acute decompensated CHF, the right pleural effusion is more frequent than left pleural effusion. All others are positive signs of CHF. On auscultation, a third heart sound and a laterally displaced apex beat may be audible. Other additional murmurs may give tips on a possible cause of CHF like mitral or tricuspid valve pathology.
#physical exam
#cardiology
References:
1. Onwuanyi A, Taylor M. Acute decompensated heart failure: pathophysiology and treatment. Am J Cardiol. 2007 Mar 26. 99 (6B):25D-30D.
2. Henes J, Rosenberger P. Systolic heart failure: diagnosis and therapy. Curr Opin Anaesthesiol. 2016 Feb. 29 (1):55-60.
A) Elevated jugular venous pressure
B) Positive hepatojugular reflux test
C) A tender and enlarged liver
D) Pleural effusion, more frequent at left
E) Leg edema
Answer: D
In acute decompensated CHF, the right pleural effusion is more frequent than left pleural effusion. All others are positive signs of CHF. On auscultation, a third heart sound and a laterally displaced apex beat may be audible. Other additional murmurs may give tips on a possible cause of CHF like mitral or tricuspid valve pathology.
#physical exam
#cardiology
References:
1. Onwuanyi A, Taylor M. Acute decompensated heart failure: pathophysiology and treatment. Am J Cardiol. 2007 Mar 26. 99 (6B):25D-30D.
2. Henes J, Rosenberger P. Systolic heart failure: diagnosis and therapy. Curr Opin Anaesthesiol. 2016 Feb. 29 (1):55-60.
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