Question

A long-standing patient of yours is experiencing acutely worsening symptoms and signs of his dilated cardiomyopathy; symptoms include fatigue, dyspnea with mild exertion, paroxysmal nocturnal dyspnea, severe lower extremity edema, clubbing, an S3 gallop, and jugulovenous distention. Medications this patient is taking daily include a β-blocker, adult dose aspirin, and an ACE inhibitor.What clinical intervention would be the most logical next step in helping resolve his current symptoms? A Initiation of a calcium channel blockerB Initiation of an aldosterone antagonistC Initiation of a statinD Initiation of a diureticE Initiation of an angiotensin II antagonist

Answer 1

The correct answer is D.

Step-by-step explanation:

This patient shows symptoms of heart failure with volume overload, particularly stage C heart failure.

Stage C includes patients who have been diagnosed with heart failure and have currently signs and symptoms of the condition.

The standard treatment for these patients should include an aldosterone antagonist (in addition to the medication already indicated in this patient).

But because he is showing symptoms of acute volume overload, it is more accurate at the moment to indicate him first a potent diuretic, such as furosemide.