RT Book, Section
A1 Chumley, Heidi S.
A1 Rivera, Nina
A1 Delzell, Jr, John E.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164345103
T1 Heart Failure
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK accessmedicine.mhmedical.com/content.aspx?aid=1164345103
RD 2024/04/20
AB A  60-year-old  man  presents  to  the  emergency  department  with  exertional  shortness  of  breath  increasing  in  severity  over  the  past  several  days,  along  with  paroxysmal  nocturnal  dyspnea  and  orthopnea.  He  does  not  have  a  history  of  heart  failure  or  previous  myocardial  infarction.  On  examination,  it  was  found  that  he  had  a  third  heart  sound  and  an  elevated  jugular  venous  pressure.  His  chest  radiograph  showed  cardiomegaly  (Figure  50-1)  and  his  B-type  natriuretic  peptide  (BNP)  was  elevated  at  600  pg/mL.  He  was  diagnosed  with  heart  failure,  evaluated  for  underlying  causes  including  coronary  artery  disease,  and  treated  initially  with  an  angiotensin-converting  enzyme  inhibitor  (ACEI)  and  a  loop  diuretic.  Later,  he  will  be  started  on  a  β-blocker  and  an  aldosterone  receptor  antagonist.