Case study: Heart failure

Mrs Brown, a 78 year-old female, was admitted to the Emergency Department at 6am after waking up with severe breathlessness. Her family informed you that the patient has a history of heart failure that had been diagnosed two years ago. On admission to the Emergency Department the clinical manifestations were:

• Severe dyspnoea

• Respiratory rate of 24 breaths/minute

• SpO2 85%, on room air

• BP 170/95mmHg

• Pulse rate of 120 beats/minute, in atrial fibrillation

• Auscultation of lungs identifies bilateral basal crackles

A diagnosis of acute exacerbation of chronic heart failure was made.

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