A 82-year-old male with a medical history of congestive heart failure (CHF) and diabetes mellitus was admitted to the hospital with complaints of dyspnea and fatigue in the last 24 hours. This was his fourth admission in the last 2 months for these symptoms. The patient had an implantable cardioverter-defibrillator (ICD) device inserted five years ago after he had sustained ventricular tachycardia during hospitalization. The patient had been on the maximum tolerated doses of diuretics, ACE inhibitors, and beta-blockers for the last six months, with increases in diuretics at each admission. The addition of a thiazide diuretic provided a modest benefit. What should be the approach to further management?

  • #cardiology
  • #critical care

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Dr. Sampath Yerramsetti

Dr. Sampath Yerramsetti

Pulmonologist

· Visakhapatnam

2D echo not mentioned? Need to classify weather it’s HfpEF or HFrEF. Definitely a Chest x ray, NT- Pro BNP, ECG, electrolytes, RFT and LFT.

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