Table 5. Major symptoms and physical findings of patients with AHF.

	Symptom	Physical and laboratory findings
Fluid retention	Orthopnea, paroxysmal nocturnal dyspnea, ascites, symptoms of gastrointestinal tract congestion	Pulmonary rales, peripheral edema, jugular venous distension, congestive hepatomegaly, hepatojugular reflux, ascites
Tissue hypoperfusion	Cold sweaty extremities, oliguria, altered mentality (confusion), dizziness	Narrow pulse pressure, metabolic acidosis, elevated serum lactate (>2 mmol/L), elevated serum creatinine, acidosis (pH <7.35)
Hypotension		Systolic blood pressure <90 mmHg
Tachycardia/Bradycardia		Heart rate >120 beats/min or <40 beats/min
Abnormal respiration		Respiratory rate >25 breaths/min with use of accessory muscles for breathing; or respiratory rate <8 breaths/min despite dyspnea
Hypoxemia		Partial pressure of oxygen (PaO2) in arterial blood <80 mmHg, arterial oxygen saturation <90%
Hypercapnia		Partial pressure of carbon dioxide (PaCO2) in arterial blood >45 mmHg
Oliguria		Urine output <0.5 mL/kg/hour

AHF = acute heart failure.