Congestive heart failure differential diagnosis

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Heart failure
ICD-10 I50.0
ICD-9 428.0
DiseasesDB 16209
MedlinePlus 000158
eMedicine med/3552 
MeSH D006333

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Template:WikiDoc Cardiology News Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis of Heart Failure

Heart Failure Secondary to Coronary Artery Disease

A. Underlying Mechanisms

  1. Ischemic Preconditioning
    • Reductions in ischemia-related apoptosis
    • Increases in endogenous adenosine
    • Activation of potassium-adenosine triphosphate (K+-ATP) channels
  2. Electrical Dysfunction
    • QT prolongation
    • Increased susceptibility to arrhythmia
    • QT dispersion
  3. Mechanical Dysfunction
    • Systolic dysfunction
    • Diastolic dysfunction
  4. Biochemical Dysfunction
    • Increases in beta-adrenergic receptor density
    • Changes in structural and regulatory proteins
    • Shift to FFA as a proffered metabolic substrate
    • Lactate production
    • Elevated BNP concentration

B. Utilisation of Clinical Data

Management of heart failure due to coronary artery disease are primarily influenced by following parameters:

  1. An estimate of the relative proportions of:
    • Viable but ischemic myocardium
    • Nonviable myocardium
    • Viable non-ischemic myocardium
  2. The technical feasibility of successful mechanical revascularization
  3. The extent and severity of comorbidities in the individual patient

Cardiomyopathies and Inflammatory Diseases

Restrictive Cardiomyopathies
Dilated Cardiomyopathies
Inflammations

Congestive Heart Failure as a Consequence of Valvular Heart Disease

Congestive Hert Failure Secondary to Congenital Heart Disease

A. Causes of Congestive Heart Failure in Adults with Unoperated Congenital Heart Diseases

B. Causes of Congestive Heart Failure in Adults with Operated Congenital Heart Diseases

Right Ventricular Failure

Factors affected right ventricle and to be eliminated during management of congestive heart failure. A. Right ventricular myocardial dysfunction

  1. Right ventricular myocardial infarction
  2. Dilated cardiomyopathy
  3. Right ventricular dysplasia

B. Primary right ventricular pressure overload

  1. Left ventricular failure
  2. Mitral valve disease
  3. Atrial myxoma
  4. Pulmonary veno-occlusive disease
  5. Cor pulmonale
  6. Pulmonic stenosis
  7. Ventricular septal defect
  8. Aortopulmonary communication

C. Primary right ventricular volume overload

  1. Pulmonic regurgitation
  2. Tricuspid regurgitation
  3. Atrial septal defect
  4. Partial anomalous pulmonary venous return

D. Impediment to right ventricular inflow

  1. Tricuspid stenosis
  2. Cardiac tamponade
  3. Constrictive pericarditis
  4. Restrictive cardiomyopathy

Differential Diagnosis of Causes of Heart Failure

A. Left Ventricular Failure

Most Common Causes:

Expanded List of Causes:

B. Right Ventricular Failure

Most Common Causes:

Other Causes:

C. Others

References

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