The Rational Clinical Examination
David L. Simel, Drummond Rennie
Heart Failure
Charlie S. Wang, J. Mark FitzGerald, Michael Schulzer, Edwin Mak, Najib T. Ayas
Clinical Scenarios
Topics Discussed:
congestive heart failure, heart failure
Excerpt:
"A 70-year-old woman with a history of a myocardial infarction
and heart failure presents to the emergency department (ED) with
a 2-day history of dyspnea at rest, orthopnea, and paroxysmal nocturnal
dyspnea. Physical examination reveals an elevated jugular venous
pressure, a third heart sound (ventricular filling gallop), bibasilar
rales and wheezing, and bilateral lower extremity edema. The chest
radiograph reveals cardiomegaly. An electrocardiogram (ECG) shows
atrial fibrillation...."
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