Congestive heart failure differential diagnosis

Overview
Congestive heart failure should be distinguished from other conditions that cause dyspnea, fatigue and edema.

Disorders That Heart Failure is Confused With
Heart failure is a clinical syndrome of dyspnea, fatigue and edema. There are several disorders that cause heart failure and should not be confused with the syndrome of heart failure.
 * Cardiac arrest and asystole refer to situations in which there is no cardiac output at all. Without urgent treatment these result in sudden death.
 * Myocardial infarction ("Heart attack") refers to heart muscle damage due to an insufficient blood supply to the heart, usually as a result of a blocked coronary artery.
 * Cardiomyopathy refers specifically to problems within the heart muscle, and these problems can result in heart failure. Ischemic cardiomyopathy implies that the cause of muscle damage is coronary artery disease. Dilated cardiomyopathy implies that the muscle damage has resulted in enlargement of the heart. Hypertrophic cardiomyopathy involves enlargement and thickening of the heart muscle.

Other Causes of Dyspnea
There are non-cardiac causes of edema that primarily involve the lung or respiratory system. These conditions are distinguished from heart failure in so far as they do not cause peripheral edema, and they are not be associated with an elevation in BNP.

Other Conditions that Cause Dyspnea that are Emergencies
The following emergency conditions should be excluded when diagnosing a patient with heart failure:
 * Asthma or bronchospasm
 * Foreign body aspiration
 * H. influenza epiglottitis
 * Spontaneous pneumothorax

Non Cardiac Causes of Dyspnea

 * Abdominal masses
 * Acute bronchitis
 * Acute Chest Syndrome
 * Acute myeloid leukemia
 * Acute promyelocytic leukemia
 * Acute tracheobronchitis
 * AIDS
 * Air pollution
 * Air-conditioner lung
 * Allergy
 * Alpha 1-antitrypsin deficiency
 * Altitude sickness
 * Amniotic fluid embolism
 * Amphotericin B
 * Amyl nitrite
 * Amyotrophic Lateral Sclerosis (ALS)
 * Anaphylactoid reactions
 * Anaphylaxis
 * Anemia
 * Anthrax
 * Anxiety
 * Asbestosis
 * Aspergillus clavatus
 * Aspiration
 * Asthma
 * Atelectasis
 * Atypical pneumonia
 * Barium
 * Beta-blockers
 * Betazole
 * Bird breeder's lung
 * Bird fancier's lung
 * Bland-White-Garland Syndrome
 * Bleomycin in ABVD
 * Blood transfusion
 * Brain stem infarction
 * Bronchial asthma
 * Bronchial tumors
 * Bronchiolitis
 * Bronchiolitis obliterans
 * Bronchiolitis obliterans organizing pneumonia
 * Bronchitis
 * Bronchogenic carcinoma
 * Bronchoscopy
 * Caspofungin
 * Cheese worker's lung
 * Chemical worker's lung
 * Chest trauma
 * Chest tube
 * Cholesterol pericarditis
 * Chronic bronchitis
 * Chronic fatigue syndrome
 * Chronic Obstructive Pulmonary Disease (COPD)
 * Chylothorax
 * Cirrhosis
 * Cladosporium
 * CMV Pneumonitis
 * Community-acquired pneumonia
 * Croup
 * Cystic Fibrosis
 * Daptomycin
 * Decompression sickness
 * Decreased thoracic or diaphragmatic excursion
 * Diabetic coma
 * Diffuse panbronchiolitis
 * Diverticulosis
 * Drugs
 * Ehrlichiosis (canine)
 * Empty nose syndrome
 * Empyema, pleural
 * Encephalitis
 * Eosinophilic pneumonia
 * Ephedrine
 * Epidemic dropsy
 * Erdheim-Chester disease
 * Esophageal cancer
 * Esophageal diseases with tracheal compression
 * Exercise-induced asthma
 * Extrinsic allergic alveolitis
 * Fat embolism
 * Fibrosing alveolitis, cryptogenic
 * Gamma-Hydroxybutyric acid
 * Gastroesophageal reflux
 * Gemeprost
 * Glatiramer acetate
 * Glottal edema
 * Goiter
 * Goodpasture syndrome
 * Grain handler's lung
 * Gram-negative sepsis
 * Guillain-Barre Syndrome
 * Hemochlyothorax
 * Hemothorax
 * Histiocytosis X
 * Hoose (disease)
 * Humidifier lung
 * Hydrochlyothorax
 * Hypersensitivity Pneumonitis
 * Hyperthyroidism
 * Hypoxia
 * Hysteria
 * Idiopathic pulmonary fibrosis
 * Iloprost
 * Interstitial lung disease
 * Intoxication (carbon monoxide, cyanide)
 * Intrapulmonary receptor stimulation
 * Intussusception (medical disorder)
 * Iron deficiency anemia
 * Irregular Heart Rhythms
 * Ketorolac
 * Kyphoscoliosis
 * Laryngeal/bronchospasm
 * Leukemia
 * Lung cancer
 * Lymphangitic metastases
 * Lymphocytic interstitial pneumonia
 * Lymphoma
 * Malignant Mesothelioma
 * Malt worker's lung
 * Mediastinal tumors
 * Megaloblastic Anemias
 * Mercury (element)
 * Metabolic acidosis
 * Methyl isocyanate
 * Micropolyspora faeni
 * Miliary tuberculosis
 * Mollusk shell hypersensitivity
 * Mucor stolonifer
 * Multiple rib fractures
 * Myasthenia Gravis
 * Myxoma
 * Neuromuscular disease
 * Obesity
 * Phrenic nerve paralysis
 * Pleural callosity
 * Pneumoconiosis
 * Pneumonia
 * Pneumochlyothorax
 * Pneumothorax
 * Pleural Effusion
 * Pleural fibrosis
 * Polyradiculitis
 * Pulmonary arteriovenous malformation
 * Pulmonary Emphysema
 * Pulmonary fibrosis
 * Quincke's Edema
 * Radiation pneumonitis
 * Respiratory tract infection
 * Sarcoidosis
 * Shock
 * Shock lung
 * Sleep Apnea Syndrome
 * Trauma
 * Tracheal stenosis
 * Tracheal tumors
 * Tracheomalacia
 * Tracheobronchial collapse
 * Uremia

Other Causes of Fatigue
There are numerous non-cardiac causes of fatigue. Again, these non-cardiac causes are not associated with dyspnea and edema.

Other Causes of Edema
Other non cardiac causes of pedal edema are listed below. Obviously, the majority of these disorders do not also cause dyspnea and fatigue, and that distinguishes them form heart failure.


 * ACE inhibitor
 * Aceon
 * Acquired C1-esterase inhibitor deficiency
 * Actos
 * Acute glomerulonephritis
 * Addison's Disease
 * Aldomet
 * Amlodipine
 * Amniotic band
 * Angioneurotic edema
 * Angiotensin converting enzyme inhibitor
 * Anemia
 * Anorexia Nervosa
 * AV fistula
 * Avandia
 * Bartter's Syndrome
 * Beta blockers
 * Boils
 * Bruise
 * Bulimia Nervosa
 * Burn
 * Cachexia
 * Carbuncle
 * Cardura
 * Cellulitis
 * Chemotherapy
 * Cisplatin
 * Cold (physical stimuli)
 * Contact dermatitis
 * Contusion
 * Cushing's Syndrome
 * Diltiazem
 * Drugs
 * Docetax
 * Erysipelas
 * Exudative enteropathy
 * Filariasis
 * Fracture
 * Frostbite
 * Gas gangrene
 * Glitazones
 * Gout
 * Hyperthyroidism
 * Hypoalbuminemia
 * Hypoplasia
 * Hypothyroidism
 * Ibuprophen
 * Idiopathic edema
 * Insect bite
 * Irritant
 * Ligamentous sprain
 * Liver failure
 * Lymph node mass
 * Malabsorption
 * Malnutrition
 * Mediastinal cancer
 * Milroy's Disease
 * Minipress
 * Motrin
 * Musculoskeletal trauma
 * Neoplasm
 * Nephrotic Syndrome
 * Nifedipine
 * Norvasc
 * Osteomyelitis
 * Peripheral nerve lesion
 * Premenstrual edema
 * Scleroderma
 * Sepsis syndrome
 * Snakebites
 * Starvation edema
 * Sunburn
 * Surgical excision
 * Tendonous strain
 * Thrombophlebitis
 * Thrombosis
 * Tight clothing
 * Trentinion
 * Trichinosis
 * Tumors
 * Univasc
 * Valproic acid
 * Varicose veins
 * Vesinoid
 * vytorin