PRognostic hEModynamIc profiling in the acUte ill eMergency department patient: PREMIUM registry

General:
18 years of age or older
Able to provide informed consent
No initiated therapy since arrival to the ED
Must be enrolled within 2 hours of arrival to the ED
Acute CHF
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
BNP level will be ordered by the treating physician as part of the patient*s work up
Acute stroke syndrome:
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
Acute Systemic Infection:
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

ESRD requiring hemo or peritoneal dialysis
Suspected pregnancy
Not able to be followed up in 30 days
Patients with *comfort only* DNR status
Patients with known STEMI
Excessive agitation
Transferred from another treating facility
Known aortic valve disease, aortic insufficiency or aortic stenosis
On continuous IV home infusions (such as milrinone, primacor)
Known Left Ventricular Assist device (LVAD)
Known prior enrollment in this study
In current therapeutic Investigational study