LETTER
Coronary Heart Failure and Left Ventricular Diastolic Dysfunction
Jalal K. Ghali
1 April 1993 | Volume 118 Issue 7 | Page 569
TO THE EDITOR:
In their comprehensive review of left ventricular diastolic dysfunction as a cause of heart failure, Bonow and Udelson [1] did not mention clinical features that would enable clinicians to recognize this condition at the bedside. In a recent study of 82 patients admitted for decompensated heart failure [2], we found that the combination of a diastolic blood pressure of 105 mm Hg or more and the absence of jugular venous distention had a specificity and positive predictive value approaching 100%. Recognizing these points should improve the clinician's ability to identify diastolic heart failure at the bedside.
1. Bonow RO, Udelson JE. Left ventricular diastolic dysfunction as a cause of congestive heart failure: mechanisms and management. Ann Intern Med. 1992; 117:502-10.
2. Ghali JK, Kadakia S, Cooper RS, Liao Y. Bedside diagnosis of preserved versus impaired left ventricular systolic function in heart failure. Am J Cardiol. 1991; 67:1002-6.
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