Clinical Diagnosis of Congestive Heart Failure in Patients with Acute Dyspnea: Methods (Part 2)

A normal (sine wave) response was characterized by the disappearance of sounds during the sustained maneuver, with reappearance after release of the maneuver. Abnormal responses included both a lack of reappearance of Korotkoff sounds after release of the maneuver (absent overshoot), or maintenance of beats throughout the maneuver (square wave).
Chest roentgenograms and electrocardiograms were obtained if ordered by the emergency room staff and were interpreted by the investigating physician in blinded fashion. The treatment of the emergency room staff was not impeded nor interfered with during this investigation. The emergency room physician responsible for the care of the patient was approached and was asked for his/her determination of the diagnosis most likely to be responsible for the patient’s dyspnea, and to indicate his/her degree of certainty in this diagnosis on a visual analog scale, ranging from 0 (diagnosis could not possibly be correct) to 1 (diagnosis could not possibly be wrong). The visual analog scale was completed in 44 of the 51 cases (86 percent). buy diabetes drugs

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