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Heart failure with preserved ejection fraction: echocardiographic VALVE protocol for emergency physicians
John M Holst1, Bret A Kilker, Sherieka Wright
1Department of Emergency Medicine, Division of Emergency Ultrasound, Johns Hopkins University, Baltimore, Maryland, USA.
Summary
Heart failure with preserved ejection fraction (HFpEF) is common in acute heart failure. Emergency physicians can use echocardiography to identify diastolic dysfunction, aiding HFpEF diagnosis.
Area of Science:
- Cardiology
- Emergency Medicine
- Medical Imaging
Background:
- Heart failure with preserved ejection fraction (HFpEF), previously diastolic heart failure, accounts for approximately 50% of heart failure cases.
- Patients with HFpEF can present with acute heart failure symptoms, complicating diagnosis.
Observation:
- Emergency physicians may overlook HFpEF if focusing solely on normal left ventricular systolic function on echocardiograms.
- Diastolic dysfunction, a key indicator of HFpEF, may be missed without specific echocardiographic evaluation.
Findings:
- Basic echocardiographic principles of diastolic dysfunction can be learned and applied in the emergency department.
- The VALVE protocol offers a focused, stepwise approach for recognizing HFpEF in fast-paced emergency settings.
Implications:
- Improved recognition of HFpEF in the emergency department through targeted echocardiography.
- Enhanced diagnostic capabilities for emergency physicians managing acute heart failure presentations.
- Timely identification of HFpEF can lead to appropriate management and improved patient outcomes.
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