Differential Diagnosis for Congestive Heart Failure
Single Most Likely Diagnosis
- Left Ventricular Systolic Dysfunction: This is the most common cause of congestive heart failure (CHF), often resulting from coronary artery disease, hypertension, or cardiomyopathy. It leads to reduced ejection fraction and impaired heart function.
Other Likely Diagnoses
- Hypertension: Uncontrolled high blood pressure can lead to heart failure by causing left ventricular hypertrophy and eventually systolic dysfunction.
- Coronary Artery Disease: Myocardial infarction (heart attack) can damage the heart muscle, leading to CHF.
- Diastolic Dysfunction: Conditions like hypertension, diabetes, and obesity can cause stiffening of the heart's ventricles, leading to diastolic heart failure.
- Valvular Heart Disease: Mitral regurgitation, aortic stenosis, and other valve disorders can increase the workload on the heart, leading to CHF.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although less common, a large pulmonary embolism can cause acute right heart failure and is potentially life-threatening if missed.
- Cardiac Tamponade: Fluid accumulation in the pericardial sac can compress the heart, leading to impaired filling and cardiac output, which is a medical emergency.
- Aortic Dissection: A tear in the aorta's wall can lead to acute aortic regurgitation, causing heart failure, and is critical to diagnose promptly.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can lead to heart failure, though they are less common causes.
Rare Diagnoses
- Restrictive Cardiomyopathy: Conditions like amyloidosis, sarcoidosis, and hemochromatosis can cause stiffening of the heart muscle, leading to restrictive filling and heart failure.
- Constrictive Pericarditis: Scarring of the pericardium can restrict heart filling, mimicking heart failure.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare genetic disorder affecting the right ventricle, leading to heart failure and arrhythmias.
- Fabry Disease: A genetic disorder leading to the accumulation of a particular type of fat in the body's cells, which can affect the heart and cause heart failure.