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Common Symptoms and Signs of Decompensated Heart Failure

Symptoms Signs
Predominantly Related to Volume Overload
Dyspnea (exertional, paroxysmal nocturnal dyspnea, orthopnea, or at rest); cough; wheezing Rales, pleural effusion
Foot and leg discomfort Peripheral edema (legs, sacral)
Abdominal discomfort/bloating; early satiety or anorexia Ascites/increased abdominal girth; right upper quadrant pain or discomfort; hepatomegaly/splenomegaly; scleral icterus
Increased weight
Elevated jugular venous pressure, abdominojugular reflux
Increasing S3, accentuated P2
Predominantly Related to Hypoperfusion
Fatigue Cool extremities
Altered mental status, daytime drowsiness, confusion, or difficulty concentrating Pallor, dusky skin discoloration, hypotension
Dizziness, presyncope, or syncope Pulse pressure (narrow)/proportional pulse pressure (low)
Pulsus alternans
Other Signs and Symptoms of Acute Heart Failure
Depression Orthostatic hypotension (hypovolemia)
Sleep disturbances S4
Palpitations Systolic and diastolic cardiac murmurs

Referensi: Braunwald's Heart Disease 8E (Saunders) 2007

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