Author + information
- Thach Nguyen1,2,3,
- Khanh Duong3,
- Vien T. Truong3,
- Thai Ba Anh Minh2,
- Luong Ngoc Tuyet Nhi2 and
- Gianluca Rigatelli4
At the present time, criteria for diagnosis of heart failure (HF) are non-specific. The symptoms or findings of HF are at the end of the disease process and there are many clinical confounders. There is a need for a specific test which can confirm the diagnosis of HF in the emergency room (ER) to guide the admission or discharge from ER.
Patients arrived to the ER with HF were enrolled. The patients in the control group received standard physical examination (PE): presence of rales in the lung and liver congestion, edema in the abdominal wall, legs, presacral area, etc. The study group underwent the ultrasound test: Size and Expansibility of the Femoral Vein (SEFV) and had treatment based on its results. The SEFV is the ultrasound study of femoral vein (FV) examining its size and expansibility with cough. The location of the femoral artery (FA) and FV to be checked is the coronal plane immediately proximal to the bifurcation of the superficial and deep femoral artery. The normal size of FV is a little larger than of the FA. If the size of the FV is twice larger than the FA, the patient has fluid overload in the intravascular compartment.
125 HF patients were enrolled. With the SEFV test, the clinicians could confirm the presence of fluid overload in all patients who had HF (100 % sensitivity) even the PE were negative for edema or intravascular fluid overload (90% specificity).
The SEFV test was more accurate in confirming the presence of fluid overload and acute heart failure than traditional PE. The diagnosis was based on the significant fluid overload in the intravascular system where the majority of the blood is circulating. The management of HF also was more successful with SEFV