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Congestive Heart Failure Differential Diagnosis

The Centers for Disease Control & Prevention report as many as five million people in the United States suffer from congestive heart failure in any given year. Conditions like coronary artery disease, high blood pressure and diabetes can all trigger symptoms of heart failure. A differential diagnosis works to identify the causes behind the condition.

  1. Congestive Heart Failure

    • Congestive heart failure is a condition that results from excessive strain on the heart muscle. Heart muscles eventually become weak and unable to pump needed amounts of blood through the body. In some cases the body will try to make the heart beat faster by raising the blood pressure level, or by retaining salt and water. Over time, these compensatory measures can become increasingly uncomfortable, prompting a person to go in for a checkup. Ultimately, blood may begin to back up inside heart chambers, veins and lungs. These conditions put a person at risk for heart attack and stroke.

    Differential Diagnosis

    • A number of conditions can cause congestive heart failure. Physicians must make a differential diagnosis in order to identify the disease and to determine its causes. To do this, physicians make a list of possible diagnoses and go about a process of elimination in order to determine the actual diagnosis. Factors taken into consideration include the presenting problem, the patient's personal and family history, blood testing, physical exam, cardiograms, and accompanying symptoms.

    Symptoms

    • The problem a patient presents with becomes the starting point in determining the cause of his condition. Patients who complain of fatigue, shortness of breath or wheezing may be exhibiting early signs of congestive heart failure. When making a differential diagnosis, the physician will take the presenting problem into account. In some cases, the types of complications a person experiences may indicate the extent of the condition. Individuals who have an abnormal heart murmur, have an enlarged heart or have kidney and liver problems may be suffering from a more advanced stage of congestive heart failure.

    Classification System

    • The New York Heart Association has put together a functional classification system that can be used within the differential diagnosis process. It's made up of four categories that help to identify what stage of heart failure a patient may be in. Class I is listed as a mild stage in which patients are able to carry out everyday activity without discomfort. In Class II --also mild- patients experience slight discomfort or fatigue when engaged in daily tasks. Class III is listed as moderate heart failure. Individuals experience significant discomfort in the form of fatigue and heart palpitations when performing daily activities. Class IV is a severe stage, leaving patients unable to carry out daily tasks without significant discomfort.

    Treatment Approach

    • The differential diagnosis process is used to identify a specific cause for congestive heart failure. Once the cause is found, treatment approaches work to reduce or eliminate its effects on the patient's overall condition. If high blood pressure is indicated, physicians can prescribe medications called ACE inhibitors, or vasodilators. These treatments are designed to expand blood walls and reduce the amount of blood flow resistance. If a weak heart chamber is the identified cause, medications called beta blockers may be prescribed to increase the heart's ability to pump blood. In cases where salt and water retention are identified, diuretics can be used to eliminate excess amounts from the body. In most cases, proper diet and exercise are a part of the treatment regimen.

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