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Use of chest radiography in the emergency diagnosis of acute congestive heart failure
  1. N Mueller-Lenke,
  2. J Rudez,
  3. D Staub,
  4. K Laule-Kilian,
  5. T Klima,
  6. A P Perruchoud,
  7. C Mueller
  1. University of Basel, University Hospital, Department of Internal Medicine and Department of Radiology, Basel, Switzerland
  1. Correspondence to:
    Dr Prof Christian Mueller
    Department of Internal Medicine, University Hospital, Petersgraben 4, CH-4031, Basel, Switzerland; chmueller{at}uhbs.ch

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The objective of the present study was to evaluate the diagnostic accuracy of chest radiography in the diagnosis of congestive heart failure (CHF) in a contemporary cohort of consecutive patients presenting with acute dyspnoea to the emergency department.

METHODS

Among 452 BASEL (B-type natriuretic peptide for acute shortness of breath evaluation) study patients,1 202 were eligible for the present analysis. We included only patients who had a chest radiograph recorded in the emergency department before or immediately after intravenous loop diuretics or vasodilators were given and when the film was read by the radiologist in charge of the emergency department. We excluded patients who presented to the emergency department with an external chest radiograph already recorded, patients who did not have chest radiography in the emergency department, and patients with no formal radiological reading available. Overall, baseline characteristics were similar in the 202 patients in the current study and the original BASEL study cohort.

The radiologist in charge of the emergency department evaluated chest radiographs obtained in the emergency department as part of the regular routine. At the time of the reading, the radiologist was unaware that this reading would be specifically analysed with regard to CHF. On the basis of the official reading of the radiograph, the presence of predefined findings was …

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