The Living Guidelines: Initial Clinical Assessment of Patients Presenting with Heart Failure. Polling Results for CLASS IIa Guidelines

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Class IIa Guidelines
1. Coronary arteriography is reasonable for patients presenting with HF who have chest pain that may or may not be of cardiac origin who have not had evaluation of their coronary anatomy and who have no contraindications to coronary revascularization. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 1 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 2. Coronary arteriography is reasonable for patients presenting with HF who have known or suspected coronary artery disease but who do not have angina unless the patient is not eligible for revascularization of any kind. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 2 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 3. Noninvasive imaging to detect myocardial ischemia and viability is reasonable in patients presenting with HF who have known coronary artery disease and no angina unless the patient is not eligible for revascularization of any kind. (Level of Evidence: B)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 3 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 4. Maximal exercise testing with or without measurement of respiratory gas exchange and/or blood oxygen saturation is reasonable in patients presenting with HF to help determine whether HF is the cause of exercise limitation when the contribution of HF is uncertain. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 4 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 5. Maximal exercise testing with measurement of respiratory gas exchange is reasonable to identify high-risk patients presenting with HF who are candidates for cardiac transplantation or other advanced treatments. (Level of Evidence: B)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 5 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 6. Screening for hemochromatosis, sleep-disturbed breathing, or human immunodeficiency virus is reasonable in selected patients who present with HF. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 6 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 7. Diagnostic tests for rheumatologic diseases, amyloidosis, or pheochromocytoma are reasonable in patients presenting with HF in whom there is a clinical suspicion of these diseases. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 7 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 8. Endomyocardial biopsy can be useful in patients presenting with HF when a specific diagnosis is suspected that would influence therapy. (Level of Evidence: C)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 8 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III 9. Measurement of B-type natriuretic peptide (BNP) can be useful in the evaluation of patients presenting in the urgent care setting in whom the clinical diagnosis of HF is uncertain. (Level of Evidence: A)

 ACC / AHA Guidelines for Diagnosis and Management of Chronic Heart Failure: Class IIa Recommendation 9 for initial clinical assessment of patients presenting with heart failure should be: CLASS I CLASS IIa CLASS IIb CLASS III