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168. Coronarinsuffizienz und Herzinfarkt

Author

Just, H., Buchborn, E., editor, Jahrmärker, H., editor, Karl, H. J., editor, Martini, G. A., editor, Müller, W., editor, Riecker, G., editor, Schwiegk, H., editor, Siegenthaler, W., editor, and Stich, W., editor more...

Published
1974
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170. Circulation

Author

Galcerà-Tomás, J., Nuño ade la Rosa, J. A., Rodriguez, P., Seller, G., Torres, G., Brù, M., Garcia-Paredes, T., Jara, P., Palazón, C., Martinez, A. Cantón, Castillo-Soria, F., Gomez-Rubl, J. A., Lukośevičiüté, A., Mickevičiené, A., Brażdżionyé, J., Doetsch, N., Marggraf, G., Schax, M., Hellinger, A., Günnicker, M., Reidemeister, J. Ch., Zehender, M., Kasper, W., Tiede, N., Elias, G., Geibel, A., Just, H., Schönthaler, M., Olschewski, M., Fumagalli, S., Breschi, M., Lotti, I., Tanganelli, S., Giagnoni, P., Cipollini, F., Ulivelli, M., Romoli, E., Scanavacca, A., Porciatti, N., Pepe, M., Lensi, A., and Valenti, F. more...

Published
1992
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172. Perspektiven der Datenverarbeitung in der klinischen Medizin

Author

Just, H., Überla, K., editor, Reichertz, P. L., editor, Victor, N., editor, Anderson, J., editor, Goos, G., editor, Gremy, F., editor, Jesdinsky, H.-J., editor, Lange, H.-J., editor, Schneider, B., editor, Segmüller, G., editor, Wagner, G., editor, Ehlers, Carl Theo, editor, and Beland, Henry, editor more...

Published
1986
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187. Clinical diagnosis of heart failure

Author

Just H

Subjects
medicine.medical_specialty, Pleural effusion, Diagnostic Techniques, Cardiovascular, Diastole, Physical examination, Diagnosis, Differential, Internal medicine, medicine, Humans, Medical History Taking, Hepatojugular reflux, Ultrasonography, Heart Failure, medicine.diagnostic_test, business.industry, Central venous pressure, General Medicine, Tricuspid insufficiency, medicine.disease, Radiography, medicine.anatomical_structure, Cardiovascular Diseases, Ventricle, Heart failure, cardiovascular system, Cardiology, business
Abstract

The clinical diagnosis of heart failure is based upon history and physical examination. Careful questioning and examination requires understanding of the pathophysiology of this systemic disorder. Symptoms and signs of congestive heart failure need to be differentiated from the manifestations of the underlying cardiovascular disorder. Only then will the specific signs and symptoms be unraveled. Symptoms arise from pulmonary congestion and peripheral or organ-underperfusion. Findings related to congestion can be found over the lungs (rales, pleural effusion), or at the jugular veins displaying either frank central venous pressure elevation or paradoxic inspiratory venous pressure rise (Kussmaul sign), or the more discrete sign of right, left of biventricular failure, the hepatojugular reflux. Dilatation and hypertrophy of the cardiac chambers can clinically easily and reliably be assessed by careful palpation. Galopprhythm, right and/or left ventricular in origin, is a particularly reliable sign of a failing ventricle. While a presystolic, atrial sound indicates merely elevated resistance to ventricular filling, i.e. the presence diastolic dysfunction or increased chamber filling, is the ventricular diastolic galopp a reliable sign of ventricular failure. Especially the appearance of a quadruple rhythm or a summation galopp can be considered both highly specific as well as prognostically dubious. Relative mitral and/or tricuspid insufficiency as a sign of ventricular dilatation needs to be differentiated from organic valve disease. This requires often echocardiography. Oedema of cardiac origin is symmetric and more pronounced in the evening. It arises both from left and from right ventricular failure. History and physical examination are both reliable tools in the initial diagnosis, as well as during follow-up and for control of therapeutic measures. Technical methods, such as chest x-ray, echocardiography or else are used for quantification and documentation. Properly applied and utilized they allow the physician to sharpen his clinical acumen, thus allowing for both a reliable diagnosis and a semi-quantitative estimation of ventricular size, enddiastolic and atrial, as well as pulmonary pressures and valve function. more...

Published
2000
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200. Buchbesprechungen

Author

Eigler, J., Schierz, G., Franke, Bock, K. D., Bock, H. E., Scriba, P. C., Just, H., Hungerland, Scriba, Hamperl, H., v. Albert, Ehrhart, H., and Theisen, K.

Published
1975
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