Heart Failure - Chronic Differential Diagnosis

Differential Diagnosis

It is important to exclude mimics of HFpEF such liver or kidney diseases, hypertrophic or infiltrative cardiomyopathy, high-output heart failure, or pericardial or valvular disease.  

Patients presenting with reduced exercise tolerance may have the medical conditions manifesting as dyspnea such as obstructive or restrictive pulmonary disease, pleural disease, pulmonary embolism, myocardial ischemia, arrhythmias, valvular heart disease, pericardial disease, anemia, and neuromuscular disease; or fatigue such as deconditioning, depression, and sleep apnea.  

Patients presenting with fluid retention (eg edema, ascites) should consider ruling out cirrhosis, drug side effects (steroids, NSAIDs, calcium channel blockers), renal sodium retention, renal failure, venous insufficiency, thrombosis, pregnancy, malnutrition, and malabsorption.