PREMIUM Registry: PRognostic HEModynamIc Profiling in the AcUtely Ill EMergency Department Patient

Inclusion Criteria

• •18 years of age or older
• •Able to provide informed consent
• •No initiated therapy since arrival to the ED
• •Must be enrolled within 4 hours of arrival to the ED
• •Recurrent or worsening (within 3 days) shortness of breath as the primary presenting ED complaint
• •Initial treating ED physician impression that the worsening dyspnea is most likely caused by decompensated CHF
• •Known history of physician diagnosed CHF
• •Natriuretic peptide (BNP, MR-pro ANP, NT pro BNP) level will be ordered by the treating physician as part of the patient's work up
• •Onset of abnormal neurological symptoms consistent with possible stroke, within the prior 24 hours, as the primary ED complaint
• •Initial treating ED physician impression that the abnormal neurological symptoms/signs are most likely caused by an acute stroke syndrome
• •Non contrast head CT will be ordered by the treating physician as part of the patient's work up
• •Any combinations of acute (within 3 days) symptoms and signs that the treating ED physician, after initial history and physical examination, attributes to a systemic infection
• •Blood cultures and/or a blood lactate will be ordered by the treating physician as part of the patient's work up