Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology.

Abstract:

:Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are global epidemics incurring significant morbidity and mortality. The combination presents many diagnostic challenges. Clinical symptoms and signs frequently overlap. Evaluation of cardiac and pulmonary function is often problematic and occasionally misleading. Echocardiography and pulmonary function tests should be performed in every patient. Careful interpretation is required to avoid misdiagnosis and inappropriate treatment. Airflow obstruction, in particular, must be demonstrated when clinically euvolaemic. Very high and very low concentrations of natriuretic peptides have high positive and negative predictive values for diagnosing HF in those with both conditions. Intermediate values are less informative. Both conditions are systemic disorders with overlapping pathophysiological processes. In patients with HF, COPD is consistently an independent predictor of death and hospitalization. However, the impact on ischaemic and arrhythmic events is unknown. Greater collaboration is required between cardiologists and pulmonologists to better identify and manage concurrent HF and COPD. The resulting symptomatic and prognostic benefits outweigh those attainable by treating either condition alone.

journal_name

Eur J Heart Fail

authors

Hawkins NM,Petrie MC,Jhund PS,Chalmers GW,Dunn FG,McMurray JJ

doi

10.1093/eurjhf/hfn013

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

130-9

issue

2

eissn

1388-9842

issn

1879-0844

pii

hfn013

journal_volume

11

pub_type

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