title: The effect of treatment on the presence of abnormal heart sounds in emergency department patients with heart failure.
abstract: OBJECTIVE
  We sought to assess the proportion of ED patients with an electronically detected S(3) or S(4), determine the relation of these heart sounds to heart failure (HF), and analyze how the proportion changes with ED treatment.
  
  
  METHODS
  Heart sounds were assessed in ED patients with suspected HF. The presence or absence of HF and whether treatment with diuretics or vasodilators had occurred were recorded.
  
  
  RESULTS
  Three hundred seventy-six patients had complete data. The proportion of patients with an S(3) and an S(4) was significantly higher for those with HF compared with those without (P < .001). Of 59 patients with HF evaluated before treatment, 57.6% had an S(3) and 35.6% had an S(4). For the 35 patients with HF evaluated after treatment, the proportions of both S(3) and S(4) were lower (28.6% and 8.6%, respectively; P < or = .0064).
  
  
  CONCLUSIONS
  This study suggests the proportion of patients with an electronically detected S(3) in HF is more than 50%, and that its presence is affected by prior treatment with diuretics or vasodilators.
authors.affiliation: Department of Emergency Medicine, University of Cincinnati, OH 45267-0769, USA. sean.collins@uc.edu
authors.forename: Sean P
authors.initials: SP
authors.lastname: Collins
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lindsell
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Virginia D
authors.initials: VD
authors.lastname: Hedger
authors.forename: Alan B
authors.initials: AB
authors.lastname: Storrow
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004232:Diuretics / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006347:Heart Sounds; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D004232:Diuretics; D014665:Vasodilator Agents