Hyponatremia in patients with CHF usually parallels the severity of heart failure and is an independent predictor of adverse clinical outcomes. This patient's clinical features - dyspnea, orthopnea, lower extremity edema, displaced apical impulse, and bilateral lung crackles - are consistent with decompensated congestive heart failure (CHF) due to left ventricular (LV) systolic dysfunction. LV = left ventricular NYHA =New York Heart Association Pro-BNP= N-terminal pro-brain natriuretic peptide VO2= oxygen consumption. Poor prognostic factors in systolic heart failure Which of the following is most likely accurate regarding this patient's condition ? Laboratory results are as follows :Įlectrocardiogram shows normal sinus rhythm and no acute ischemic changes. Bilateral crackles are present over the lower lobes.
Point of maximal impulse is displaced to the left and a soft holosystolic murmur is heard at the apex. Symmetric 2+ pitting edema of the lower extremities is present. His blood pressure is 135/80 mm Hg, and pulse is 75/min and regular. Current medications include metoprolol, digoxin, enalapril, furosemide, spironolactone, and aspirin. His past medical history is significant for hypertension, type 2 diabetes mellitus, myocardial infarction 8 years ago, and congestive heart failure. Cardiology Clinical Case / MCQS / Uworld for Usmle step 2 / case 2 with answer and explanation and references and Educational objectiveĪ 68-year-old man comes to the emergency department with a 3-week history of progressive dyspnea, orthopnea, and lower extremity edema.
0 kommentar(er)
