RT Book, Section
A1 Roy, Swathi
A1 Kamalakkannan, Gayathri
A2 Saad, Muhammad
A2 Bhandari, Manoj
A2 Vittorio, Timothy J.
SR Print(0)
ID 1166697018
T1 10 Real Cases on Acute Heart Failure Syndrome: Diagnosis, Management, and Follow-Up
T2 Patient Management in the Telemetry/Cardiac Step-Down Unit: A Case-Based Approach
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260456998
LK accessmedicine.mhmedical.com/content.aspx?aid=1166697018
RD 2024/04/23
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?