Yes, and they involve most of the five “fingers” of the cardiovascular exam. On the venous side, for example, the presence of either end-inspiratory crackles or distended neck veins has high specificity (90–100%) but low sensitivity (10–50%) for increased left-sided filling pressure due to either systolic or diastolic dysfunction.
Of these two signs, only an elevated jugular venous pressure has a significant positive likelihood ratio (3.9).
Positive abdomino jugular reflux has equally high specificity, but better sensitivity (55–85%), and an
even stronger likelihood ratio (8.0). S3 gallop, downward and lateral displacement of the apical impulse, and peripheral edema also have high specificity (>95%) but low sensitivity (1–40%) for elevated diastolic filling pressures; of them, only the S3 and the displaced apical impulse have a positive likelihood ratio (5.7 and 5.8, respectively).
Given their negative likelihood ratios, only an absent abdominojugular reflux and an abnormal Valsalva
response argue against the presence of high filling pressures. Finally, S4 has high sensitivity (71%), but
low specificity (50%), and nonsignificant likelihood ratios.
Of these two signs, only an elevated jugular venous pressure has a significant positive likelihood ratio (3.9).
Positive abdomino jugular reflux has equally high specificity, but better sensitivity (55–85%), and an
even stronger likelihood ratio (8.0). S3 gallop, downward and lateral displacement of the apical impulse, and peripheral edema also have high specificity (>95%) but low sensitivity (1–40%) for elevated diastolic filling pressures; of them, only the S3 and the displaced apical impulse have a positive likelihood ratio (5.7 and 5.8, respectively).
Given their negative likelihood ratios, only an absent abdominojugular reflux and an abnormal Valsalva
response argue against the presence of high filling pressures. Finally, S4 has high sensitivity (71%), but
low specificity (50%), and nonsignificant likelihood ratios.