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ContextDyspnea is a common complaint in the emergency department where physicians must accurately make a rapid diagnosis.ObjectiveTo assess the usefulness of history, symptoms, and signs along with routine diagnostic studies (chest radiograph, electrocardiogram, and serum B-type natriuretic peptide [BNP]) that differentiate heart failure from other causes of dyspnea in the emergency department.Data SourcesWe searched MEDLINE (1966-July 2005) and the reference lists from retrieved articles, previous reviews, and physical examination textbooks.Study SelectionWe retained 22 studies of various findings for diagnosing heart failure in adult patients presenting with dyspnea to the emergency department.Data ExtractionTwo authors independently abstracted data (sensitivity, specificity, and likelihood ratios [LRs]) and assessed methodological quality.Data SynthesisMany features increased the probability …