To the Editor.—Dr Kessler's article in the October 1988 issue of the Archives1 was useful in regard to heart failure secondary to diastolic dysfunction. One statement that I feel needs correction is"... that the signs and symptoms of heart failure are not specific, but rather are subjective, and may be manifestations of noncardiac disorders."
Signs of heart failure, such as S3 gallop and pulsus alternans, are objective findings felt to be pathognomonic of heart failure according to the traditional teachings of physical diagnosis. Although these signs may not be sensitive in patients with diastolic dysfunction, as pointed out by Dr Kessler, they remain specific signs of heart failure.
MURPHY PK. Heart Failure Secondary to Diastolic Dysfunction. Arch Intern Med. 1989;149(7):1695. doi:10.1001/archinte.1989.00390070193036
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.