Heart failure Discussion Paper

A 50yo African American woman presents to clinic feeling tired for the last 3 months.  She also has trouble breathing when walking 2-3 blocks.  She sleeps on 2 pillows at night to help with her breathing.  PMH:  HTN, arthritis.  Physical exam: edema present in both feet.  Medications:  HCTZ 12.5mg daily, verapamil SA 120 mg daily, ibuprofen 200 mg BID for arthritis in knee.  Vitals:  height 5’2″, 63kg, BP 134/84, HR 78, EF 30% per echocardiogram.  Her labs are normal including a creatinine of 1.1.  She denies chest pain or palpitations.  Her EKG reveals normal sinus rhythm with no evidence of ischemia or recent acute coronary syndrome.Heart failure Discussion Paper

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  1. How would you classify her heart failure?
  2. What changes (modifications, additions, deletions) to her medications do you recommend that will:
    • Improve her symptoms?
    • Impact long term outcomes?
  3. What monitoring parameters do you recommend?
  4. What non-pharmacologic recommendations do you have?

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses should be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to the Grading Rubric for Online Discussion in the Course Resource section.Heart failure Discussion Paper