Marantz P R, Kaplan M C, Alderman M H
Department of Epidemiology and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467.
Chest. 1990 Apr;97(4):776-81. doi: 10.1378/chest.97.4.776.
The validity and utility of physical examination maneuvers were determined in diagnosing congestive heart failure (CHF) in patients with acute dyspnea. Fifty one patients presented to the emergency room with the chief complaint of shortness of breath. History and physical examination were obtained independently, and the physical examination included hepatojugular reflux and the Valsalva maneuver. The diagnosis of CHF was made by predetermined criteria, and was compared with the diagnosis of the emergency room (ER) physician and with the response to bedside maneuvers. The hepatojugular reflux and Valsalva maneuvers were valid in the diagnosis of congestive heart failure in acutely dyspneic patients. Although these maneuvers rarely added to the routine assessment of patients in this study, they may provide a useful, noninvasive adjunct to clinical diagnosis in problematic cases.
对急性呼吸困难患者进行体格检查操作以诊断充血性心力衰竭（CHF）的有效性和实用性进行了评估。51例因呼吸急促为主诉前来急诊室就诊的患者。独立获取病史和体格检查结果，体格检查包括肝颈静脉回流征和瓦尔萨尔瓦动作。CHF的诊断依据预先确定的标准进行，并与急诊室（ER）医生的诊断以及床边操作的反应进行比较。肝颈静脉回流征和瓦尔萨尔瓦动作在急性呼吸困难患者充血性心力衰竭的诊断中是有效的。尽管在本研究中这些操作很少能为患者的常规评估增加有用信息，但在疑难病例中它们可能为临床诊断提供一种有用的非侵入性辅助手段。
