A 52 year old female arrives at the emergency department complaining of shortness of breath for the past three days which has gotten progressively worse. Her shortness of breath is worse when lying down and with exertion. She complains of a cough, especially at night. The patient also notes increased swelling in her legs bilaterally and well as mild substernal chest pressure.
The patient has a history of hypertension, diabetes and a prior myocardial infarction. Her vital signs are as follows: BP 210/106, HR 118, RR 26, T 98.2. On exam you note rales in the lung bases bilaterally as well as 1+ pitting edema in the lower extremities bilaterally. The patient is sitting up and in no acute respiratory distress. Her oxygen saturation is 94%.
Vital signs 180/96, HR 120, RR 24, Temp 98.0, Pulse Ox 92%, The patient is still edematous and short of breath. Patient states she still feels the same.
Vital signs 156/81. HR 99, RR 20, Temp 97.9, Pulse Ox 94%. The patient has less edema, and shortness of breath. She feels better and she is able to walk to the bathroom with assistance.
What is CHF?
What is right sided heart failure? How does it manifest? What is left sided heart failure? How does it manifest?
What are the causes or risk factors for CHF?
What medications would you expect this patient to be prescribed?
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