A 63-years-old woman comp...

A 63-years-old woman complaining shortness of breath (dypsnoea) since 2 hours ago. She also presented with cough, palpitations, and excessive of sweating (diaphoresis). Shortness of breath get worsed by lying down, and better when sitting. She has hypertension, diabetic, and pneumonia as past medical history. Vital signs showed increased of BP 220/120 mmHg, HR 120x/min, RR 32x/min, T 36,1 C, Sa02 83% on room air. On physical examination, there were rhonchi and wheezes at the whole of lungs. The patient was diagnosed by acute lung oedema (ALO) with hypertensive emergency. The patient was treated by oxygen with NRM 15 lpm, continuous IV of furosemide 20 mg/hour, continuous IV of cedocard (ISDN) 10 mg/hour with titration dose based on vital signs and clinical examination.