TY - CHAP M1 - Book, Section TI - 10 Real Cases on Acute Heart Failure Syndrome: Diagnosis, Management, and Follow-Up A1 - Roy, Swathi A1 - Kamalakkannan, Gayathri A2 - Saad, Muhammad A2 - Bhandari, Manoj A2 - Vittorio, Timothy J. Y1 - 2020 N1 - T2 - Patient Management in the Telemetry/Cardiac Step-Down Unit: A Case-Based Approach AB - A 54-year-old woman presented to the telemetry floor with shortness of breath (SOB) for 4 months that progressed to an extent that she was unable to perform daily activities. She also used 3 pillows to sleep and often woke up from sleep due to difficulty catching her breath. Her medical history included hypertension, dyslipidemia, diabetes mellitus, and history of triple bypass surgery 4 years ago. Her current home medications included aspirin, atorvastatin, amlodipine, and metformin. No significant social or family history was noted. Her vital signs were stable. Physical examination showed bilateral diffuse crackles in lungs, elevated jugular venous pressure, and 2+ pitting lower extremity edema. ECG showed normal sinus rhythm with left ventricular hypertrophy. Chest x-ray showed vascular congestion. Laboratory results showed a pro-B-type natriuretic peptide (pro-BNP) level of 874 pg/mL and troponin level of 0.22 ng/mL. Thyroid panel was normal. An echocardiogram demonstrated systolic dysfunction, mild mitral regurgitation, a dilated left atrium, and an ejection fraction (EF) of 33%. How would you manage this case? SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/10 UR - accessmedicine.mhmedical.com/content.aspx?aid=1166697018 ER -