Also see: Acute Cardiogenic Pulmonary Oedema

• History
  • Has a fluid restriction been prescirbed? If so, is the patient compliant?
  • Last echocardiogram report
  • Past medical history (e.g. hypertension and previous myocardial infarctions)
  • Current medications and allergies
  • Is there any Iron Deficiency Anaemia
  • Severity of exertional dyspnoea and usual exercise tolerance
  • New York Association functional classification of heart failure
  • Are symptoms of dyspnoea stable or worsening
  • Chest pain either at rest or on exertion
  • Any history of palpitations
  • Social supports at home
• Exam
  • General appearance
  • Vital signs
    • Heart failure Beta blocker are recommended to be started when the patient is euvolaemic and up-titrated every 2–4 weeks to target or maximum tolerated dose
  • Chest auscultation — bibasal fine crackles ⇒ pulmonary oedema
  • Peripheral oedema
  • Cardiac auscultation
• Investigations
  • ECG
  • Chest X ray
  • Bloods
    • FBC
    • Serial troponin
    • UEC
  • Echocardiogram
• Consider other causes of cardiac decompensation
  • Anaemia
  • Hypoalbuminaemia in renal, hepatic or gastrointestinal diseases
  • Hypperthyroidism or hypothyroidism