View Post

Initiation of Congestive Heart Failure Action Plan in the Emergency Department

In Medical Concepts by Anthony LauLeave a Comment

A 72-year-old English-speaking male with a history of congestive heart failure (CHF) withreduced ejection fraction (EF) presented to the emergency department (ED) with acutedecompensated CHF. He had a two-year history of progressive dyspnea and exercise intolerance.Other comorbidities included coronary artery disease, hypertension, dyslipidemia, cardioembolicstroke, and gastroesophageal reflux disease. His medications included furosemide, apixaban,atorvastatin, carvedilol, and fosinopril. His furosemide was reduced from 40 mg to 20 mg daily by hisfamily physician five months prior …

View Post

Clinical Question: How does the sensitivity/specificity of lung ultrasound compare to plain films in diagnosing acute decompensated heart failure?

In Clinical Questions by Neil SenguptaLeave a Comment

A 64 year old woman presents to the emergency department with dyspnea.  On exam she is mildly tachypneic, has an oxygen saturation of 94% on 2L nasal prongs, and bilateral crackles to auscultation.  You suspect acute heart failure and wonder about the role of lung ultrasound as you await her chest x-ray.   Clinical question: What is the sensitivity and specificity of lung PoCUS compared to chest radiograph for diagnosis of acute decompensated …