Utility of History, Physical Examination, Electrocardiogram, and ...
Utility of History, Physical Examination, Electrocardiogram, and ...
Utility of History, Physical Examination, Electrocardiogram, and ...
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Table 3. Characteristics <strong>of</strong> Patients with a Left Ventricular Ejection Fraction 30% Compared with 30%<br />
Characteristic<br />
Ejection Fraction<br />
30%<br />
(n 136)<br />
Ejection Fraction<br />
30%<br />
(n 89) P Value<br />
Number (%) or Mean SD<br />
Age (years) 58 14 53 13 0.008<br />
Age 60 years 67 (50) 34 (39) 0.10<br />
Male sex<br />
Risk factors<br />
65 (49) 60 (67) 0.004<br />
Hypertension 108 (81) 61 (69) 0.04<br />
Diabetes mellitus 55 (41) 27 (30) 0.10<br />
Hyperlipidemia 8 (6) 5 (6) 0.91<br />
Smoking 54 (41) 40 (45) 0.52<br />
Obesity (body mass index 30 kg/m 2 )<br />
Other conditions<br />
75 (61) 36 (44) 0.01<br />
<strong>History</strong> <strong>of</strong> coronary disease 32 (24) 27 (30) 0.29<br />
Chronic renal failure 20 (15) 7 (8) 0.11<br />
Alcohol use<br />
Medications<br />
29 (22) 36 (40) 0.003<br />
ACE inhibitors 88 (67) 76 (85) 0.002<br />
Diuretics 124 (94) 84 (94) 0.89<br />
Beta-blockers 25 (19) 6 (7) 0.01<br />
Digoxin 39 (30) 56 (63) 0.001<br />
Calcium antagonists 41 (32) 10 (11) 0.001<br />
Hydralazine<br />
Symptoms<br />
21 (16) 8 (9) 0.14<br />
Dyspnea at rest 52 (39) 40 (45) 0.39<br />
Dyspnea on exertion 132 (98) 87 (99) 0.55<br />
Orthopnea 114 (85) 76 (87) 0.64<br />
Paroxysmal nocturnal dyspnea 98 (75) 65 (76) 0.86<br />
Angina 11 (8) 6 (7) 0.71<br />
Nonanginal chest pain<br />
<strong>Physical</strong> examination<br />
49 (36) 21 (24) 0.05<br />
Heart rate (beats per minute) 92 20 102 20 0.001<br />
Heart rate 100 beats per minute 46 (35) 47 (53) 0.005<br />
Systolic blood pressure (mm Hg) 162 39 139 27 0.001<br />
Systolic blood pressure 160 mm Hg 67 (50) 17 (19) 0.001<br />
Diastolic blood pressure (mm Hg) 92 26 88 16 0.15<br />
Diastolic blood pressure 110 mm Hg 32 (24) 9 (10) 0.01<br />
Pulse pressure (mm Hg) 70 26 51 19 0.001<br />
Pulse pressure 60 mm Hg 89 (66) 27 (31) 0.001<br />
Jugular venous distention 91 (69) 69 (79) 0.09<br />
Pedal edema 113 (84) 63 (71) 0.02<br />
Rales 111 (82) 80 (90) 0.09<br />
S3 gallop 33 (29) 34 (45) 0.02<br />
S4 gallop<br />
<strong>Electrocardiogram</strong><br />
Rhythm<br />
14 (12) 2 (3) 0.02<br />
Sinus rhythm 108 (82) 72 (83) 0.91<br />
Atrial fibrillation 21 (16) 10 (11) 0.46<br />
Other rhythm 2 (2) 5 (6) 0.18<br />
Abnormal Q waves 26 (20) 17 (20) 0.98<br />
Left ventricular hypertrophy 36 (27) 35 (41) 0.04<br />
Left atrial abnormality<br />
Chest radiograph<br />
34 (30) 43 (52) 0.001<br />
Cardiomegaly 114 (86) 83 (97) 0.01<br />
Cephalization 107 (80) 80 (93) 0.01<br />
Pulmonary edema 17 (13) 14 (16) 0.47<br />
Pleural effusion 34 (26) 15 (17) 0.16<br />
ACE angiotensin-converting enzyme.<br />
Clinical Findings in Heart Failure/Thomas et al<br />
442 April 15, 2002 THE AMERICAN JOURNAL OF MEDICINE Volume 112