Congestive heart failure - Diagnosis

Three diagnostic pitfalls: The difficulty in diagnosing congestive heart fa ilure in the elderly subject is basically caused by three factors. First, c linical expression is often atypical. Secondly, severity is often underesti mated as the prevalence of asymptomatic systolic dysfunction increases with age. Half of ail cases of left ventricular systolic dysfunction go unrecog nized if clinical signs alone are considered. Finally, the pathophysiology of diastolic dysfunction, which predominates in the over 75 population, is still poorly understood. Complementary explorations: As the clinical signs are the same whatever the mechanism of the ventricular dysfunction, echocardiography is the key expl oration for diagnosis and for guiding management. Comorbidity is often conf ounding factor preventing precise diagnosis and risk stratification. (C) 19 99, Masson, Paris.