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On the heart failure diagnosis. Is it enough with physical examination?
Sobre el diagnóstico de la insuficiencia cardíaca: ¿es suficiente con la exploración física?
a Servicio de Prestaciones y Atención al Usuario, Dirección General de Humanización, Prestacionesy Farmacia, Consejería de Salud, Gobierno de La Rioja, Logroño. Spain
b MedicinaFamiliar yComunitaria, Servicio Riojano de Salud, Logroño, Spain
c Área de Formación, Calidad, I + D + i de Enfermería, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro de Salud, Santander, Spain
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"tieneTextoCompleto" => true "saludo" => "Dear Director," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "621" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Velasco Montes, S. González Díez, E. Rivas Cilleros" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Velasco Montes" "email" => array:1 [ 0 => "javier_velasco_montes@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "González Díez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Rivas Cilleros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Prestaciones y Atención al Usuario, Dirección General de Humanización, Prestacionesy Farmacia, Consejería de Salud, Gobierno de La Rioja, Logroño. Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "MedicinaFamiliar yComunitaria, Servicio Riojano de Salud, Logroño, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Área de Formación, Calidad, I + D + i de Enfermería, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro de Salud, Santander, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sobre el diagnóstico de la insuficiencia cardíaca: ¿es suficiente con la exploración física?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the brief original article <span class="elsevierStyleItalic">Clinical characteristics and risk factors for mortality on admission in patients with heart failure hospitalized due to COVID-19 in Spain</span>,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> the authors explain that the diagnosis of heart failure was established according to the clinical parameters of congestion on the medical record (dyspnea, edema, and increase in jugular venous pressure). Although the aforementioned triad is classical when diagnosing heart failure, we think it is problematic to rely only a physical examination for making a diagnosis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">For example, although the presence of elevated jugular venous pressure is a very specific sign, it is one that is difficult to detect, with a low level of agreement among physicians when observing it in a specific patient.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In our opinion, it is very noteworthy that in this work also did not gather natriuretic peptide (BNP or NT-proBNP) values which, according to various scientific works, can be useful in patients with an intermediate probability of heart failure.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> In fact, the Spanish Society of Internal Medicine’s Heart Failure and Atrial Fibrillation Working Group includes the determination of NT-proBNP within its acute heart failure management protocol (version published in 2022). If said variables had been included in the analysis, it is possible that the conclusions would also have been different.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Velasco Montes J, González Díez S and Rivas Cilleros E. Sobre el diagnóstico de la insuficiencia cardíaca: ¿es suficiente con la exploración física? Revista Clínica Española. 2022. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.rce.2022.05.004">https://doi.org/10.1016/j.rce.2022.05.004</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Características clínicas y factores de riesgo de mortalidad al ingreso en pacientes con insuficiencia cardíaca hospitalizados por COVID-19 en España" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Salinas-Botrán" 1 => "J. Sanz-Cánovas" 2 => "J. Pérez-Somarriba" 3 => "L.M. Pérez-Belmonte" 4 => "L. Cobos-Palacios" 5 => "M. 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