10
Assessment
Table 5. Other Potential Nonischemic Causes of HF
• Chemotherapy and other cardiotoxic medications
• Rheumatologic or autoimmune
• Endocrine or metabolic (thyroid, acromegaly, pheochromocytoma, diabetes, obesity)
• Familial cardiomyopathy or inherited and genetic heart disease
• Heart rhythm–related (e.g., tachycardia-mediated, PVCs, RV pacing )
• Hypertension
• Infiltrative cardiac disease (e.g., amyloid, sarcoid, hemochromatosis)
• Myocarditis (infectious, toxin or medication, immunological, hypersensitivity)
• Peripartum cardiomyopathy
• Stress cardiomyopathy (Takotsubo)
• Substance abuse (e.g., alcohol, cocaine, methamphetamine)
4. Initial and Serial Evaluation
4.1. Clinical Assessment: History and Physical Examination
COR LOE
Recommendations
1 B-NR 1. In patients with HF, vital signs and evidence of clinical
congestion should be assessed at each encounter to guide
overall management, including adjustment of diuretics and
other medications.
1 B-NR 2. In patients with symptomatic HF, clinical factors indicating
the presence of advanced HF should be sought via the history
and physical examination.
1 B-NR 3. In patients with cardiomyopathy, a 3-generation family history
should be obtained or updated when assessing the cause of the
cardiomyopathy to identify possible inherited disease.
1 B-NR 4. In patients presenting with HF, a thorough history and
physical examination should direct diagnostic strategies to
uncover specific causes that may warrant disease-specific
management.
1 C-EO 5. In patients presenting with HF, a thorough history and
physical examination should be obtained and performed
to identify cardiac and noncardiac disorders, lifestyle and
behavioral factors, and social determinants of health that
might cause or accelerate the development or progression of
HF.
