Congestive Heart Failure
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General Info

HPI/Physical

Congestive heart failure is pulmonary edema secondary to left sided heart failure. This is not something that sponteously occurs, in other words, congestive heart failure is not a primary occurance, it is always secondary to some other cause. The most common precipitating factors are 1. tachyarrhythmias, 2. ACS/MI, 3. Increased salt intake, 4. Overexertion, 5. Medication noncompliance, 6. Medications that decrease cardiac function

History: Dyspnea, Productive cough, Orthopnea, PND, LE Swelling Symptoms: Tachycardia, Hypertension, Frothy pink sputum, JVD, S3 Gallop, Respiratory distress, Rales, Retractions, Accessory muscle use, LE pitting edema Signs:

Tests/Diagnosis Management Disposition ECG Chest x-ray Comprehensive CBC Cardiac enzymes BNP ABG Lactate Echocardiogram Stress test Cardiac Monitoring Strict I/Os Fluid restriction Nitroglycerin ACE inhibitor Lasix Aspirin Oxygen Morphine Dopamine BiPAP Admit to medicine telemetry. Rule out MI Echocardiogram Evaluation for AICD