diagnosis
the lack of a universally accepted defination of CHF represents a problem in diagnosis. although CHF is commonly defined as inability of the heart to pump blood at a rate suffient to meet metabolic demands or to do so only at an clevated filling pressure, clinicians require a more practical description
However, in older patients the clinical diagnosis of heart failure may be difficult because of the absence of typical symptom and sign. Many older patients may not have dysponea on exertion because of their sedentary lifestyle