[Usefulness of echocardiography in heart insufficiency: a prospective study of 100 patients]

We prospectively evaluated 100 patients with heart failure, grades III and IV of the NYHA who were admitted to our Internal Medicine Service. In all cases a clinical diagnosis previous to the recording of the echocardiogram was made to evaluate the contributions of the latter. In 26 patients the echocardiogram gave information which had not been anticipated from the history and basic studies. This information resulted in a change of diagnosis in 21 cases and in the addition of a diagnosis with therapeutic and/or prognostic implications in 5 cases. It also permitted an approach to pathogenesis in the subgroup with preserved systolic function (36%), which were categorized as having diastolic dysfunction. On the other hand, the echocardiogram permitted the definition of the group of elderly patients, with heart failure and without previously known heart disease, which we considered as having senile heart disease.