CHF mislabeled as COPD

Karen Cosby kcosby40 at GMAIL.COM
Wed Jan 22 15:57:01 UTC 2014

Yes we recognize this is a common problem, although more with patients
labeled as asthma.  In part it's because both conditions may occur in the
same patient.  Patients in the ED often have longstanding and poorly
controlled asthma/COPD, and many have right heart failure with edema.
Detecting new CHF in those patients can be difficult.  It even more
problematic because asthmatics in many EDs are triaged to an area where
they are treated in chairs and aren't undressed for a full exam.  We
recognized this as a problem and developed standard questionnaires for
examiners to complete specifically targeting questions to elicit signs and
symptoms that might require a more thorough exam/evaluation for alternative
conditions.  We tell our residents that one of the main priorities we
expect in the evaluation of asthma is to detect conditions other than
asthma.  We haven't tried to quantitate this problem, but have it among our
list of common causes of mis-diagnoses.

On Mon, Jan 20, 2014 at 9:22 PM, Abdul Saadi <essadii at> wrote:

> Anyone aware of good literature on the mislabeling of CHF as COPD? Is
> there any estimates. Is this a problem that anyone sees with any frequency
> or is it just me? Is it slipping stethoscope skills or failure to take into
> account the whole patient presenation?
> Abdul Saadi,MD
> Temple University
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