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CLINICAL REVIEW: Allan D Struthers Atypical features make echocardiography mandatory in suspected heart failure BMJ 2004; 328: 945 [Full text]

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Pleural effusion and heart failure

Syed Wamique Yusuf   (18 April 2004)

Pleural effusion and heart failure 18 April 2004
Syed Wamique Yusuf, Assistant Professor of Medicine University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA Send response to journal: Re: Pleural effusion and heart failure	I agree with Dr Struthers comments that an echocardiography should be mandatory in all cases of suspected heart failure, but even in this age of technology bedside diagnosis and clincial evaluation remains crucial in the management of these patients.In our institution where we have a fair number of pleural effusions due to malignancy, we not uncommonly see patients with bilateral effusion purely due to diastolic heart failure. These patients usually have a very high BNP level and unless they have some concomitant etiology for their pleural effusion, they respond quickly and favourably to diuretics and nesiritide infusion. Competing interests: None declared