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Figure 2 Evaluation of Heart Failure in Stable COPD Patients

Two-dimensional (2D) Doppler echocardiography is indicated in patients with stable chronic obstructive pulmonary disease (COPD). A normal (Nl) echocardiogram (echo) excludes chronic heart failure (CHF). No further therapy () is needed. When left ventricular (LV) ejection fraction (EF) is 40%, full CHF therapy, including beta-blockade, is recommended. When LVEF is >40%, LV mass is increased, and left atrium is enlarged, the diagnosis of diastolic heart failure needs to be entertained and therapy with angiotensin-converting enzyme (ACE) inhibitors and diuretics considered. When the echocardiogram is technically (Tech.) inadequate, radionuclide ventriculography (RNV) is indicated and therapy needs to be adjusted to the findings. Imp. = impaired.