1. Heart failure Diagnosis & Differential Diagnosis Manoz marwin-- 22/3/20141

2. Diagnosis Routine laboratory testing Electrocardiogram Chest X-ray Assessment of LV function Biomarkers Exercise testing 22/3/20142

3. Routine laboratory testing Complete blood count Panel of electrolytes Blood urea nitrogen Serum creatinine Hepatic enzymes Urinalysis Fasting serum glucose Oral glucose tolerance Fasting lipid panel Thyroid-stimulating hormone level Diabetic patients Dyslipidemia Thyroid abnormalities22/3/20143

4. Electrocardiogram (ECG) To asses cardiac rhythm To determine the presence of LV hypertrophy Old or recent MI To ascertain whether the patient may benefit from resynchronization therapy Presence or absence of Q waves QRS width 22/3/20144

5. Chest X-ray 22/3/20145 Cardiac size & shape State of pulmonary vasculature Identify noncardiac causes of the patients symptoms

6. Assessment of LV function 22/3/20146 2D echocardiogram/Doppler Magnetic resonance imaging (MRI)

7. 2D echocardiogram/Doppler 22/3/20147 Provide a semiquantitative assessment of LV size & function Presence/absence of valvular and/or regional wall motion abnormalities Assess RV size & pulmonary pressures evaluating and management of cor pulmonale The presence of left atrial dilatation and LV hypertrophy + abnormalities of LV diastolic filling provided by pulse-wave and tissue Doppler useful for the assessment of HF with a preserved EF.

8. Magnetic resonance imaging (MRI) 22/3/20148 Analysis of cardiac anatomy and function Gold standard for assessing LV mass and volumes Determining the cause of HF

9. 22/3/20149 EF - most useful index of LV function EF - easy to measure by noninvasive testing EF - normal (>50%) adequate systole function EF - depressed (