Physical Exam as Good as High Tech in Assessing Heart Failure

Estimates of fluid in body compared favorably to results of invasive procedure, study finds

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FRIDAY, Sept. 26, 2008 (HealthDay News) -- A physical exam and patient history may still be one of the most accurate and cost-effective ways of assessing patients with congestive heart failure, even though doctors have come to rely on high-tech diagnostic methods such as imaging and measuring biomarkers, a new study says.

"There has been a shift away from the use of the history and physical examination in patient care. The key objective of this study was to uncover whether the history and physical examination remains useful in the modern era," lead author Dr. Mark Drazner, medical director of the Heart Failure and Cardiac Transplantation Program at the University of Texas Southwestern Medical Center at Dallas, said in a school news release.

History and physical examinations were performed for 388 congestive heart failure patients. About half of them also underwent invasive right-heart catheterization to measure how much fluid they had in their body.

The history and physical exam-based estimates of the amount of fluid in the body compared favorably to the results of the invasive procedure. The study also found that patients estimated to have extra fluid after collection of histories and physical exams were more likely to be hospitalized or die within six months.

The findings were published in the journal Circulation: Heart Failure.

"Our study touches upon an important clinical question: If physicians were more adept at performing histories and physicals, would they rely less on more costly diagnostic tests?" Drazner said.

"Hopefully, this study might shift the pendulum back just a bit toward using the history and physical examination in patient care. It might even get trainees more interested in learning about the history and physical examinations so that this important art can be perpetuated in future generations of physicians," he added.

More information

The American Heart Association has more about heart failure.

SOURCE; University of Texas Southwestern Medical Center at Dallas, news release, Sept. 16, 2008

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