Which finding would support the diagnosis of heart failure (HF)?

Question

1. RA/CVP of 8 mm Hg
2. PAWP of 20 mm Hg
3. Cardiac index of 3
4. Peripheral vasodilation reflected by normalizing capillary refill times

Answer 1

2
Rationale 1: The RA/CVP are increased with rising pressures to push through the inadequate pumping that occurs with heart failure from systemic venous pressure elevations from ascites and peripheral edema.
Rationale 2: With heart failure the backup of fluid from inadequate pumping results in increased PAWP because the heart has to pump harder to push through the rising capillary pressures on the venous side from peripheral edema and ascites.
Rationale 3: Cardiac output is decreased with heart failure because the preload volume continues to rise with a less efficient pump to remove the blood.
Rationale 4: Peripheral vasoconstriction occurs and capillary refills are sluggish and delayed.