RT Book, Section
A1 Katzung, Bertram G.
A2 Katzung, Bertram G.
SR Print(0)
ID 1148434296
T1 Drugs Used in Heart Failure
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accesspharmacy.mhmedical.com/content.aspx?aid=1148434296
RD 2024/04/19
AB CASE  STUDYA  55-year-old  man  noticed  shortness  of  breath  with  exertion  while  on  a  camping  vacation  in  a  national  park.  He  has  a  15-year  history  of  poorly  controlled  hypertension.  The  shortness  of  breath  was  accompanied  by  onset  of  swelling  of  the  feet  and  ankles  and  increasing  fatigue.  On  physical  examination  in  the  clinic,  he  is  found  to  be  mildly  short  of  breath  lying  down  but  feels  better  sitting  upright.  Pulse  is  100  bpm  and  regular,  and  blood  pressure  is  165/100  mm  Hg.  Crackles  are  noted  at  both  lung  bases,  and  his  jugular  venous  pressure  is  elevated.  The  liver  is  enlarged,  and  there  is  3+  edema  of  the  ankles  and  feet.  An  echocardiogram  shows  an  enlarged,  poorly  contracting  heart  with  a  left  ventricular  ejection  fraction  of  about  30%  (normal:  60%).  The  presumptive  diagnosis  is  stage  C,  class  III  heart  failure  with  reduced  ejection  fraction.  What  treatment  is  indicated?