This patient is a 70-year-old male who required inpatient hospitalization due to concerns for acute exacerbation of congestive heart failure. He was presented to the emergency department due to the complaints of pain in the sub sternal/epigastric region accompanied by productive cough which worsen by movements. The pain was described as mild to moderate, constant and dull. His past medical history was suggestive of cardiomyopathy and hypertension. It was noted that he underwent cardiac catheterization 10 years ago. Furthermore the patient reported having flu-like symptoms 2 weeks ago and several days of productive cough with subjective fever and chills.
Initially, her blood pressure was 100/57 mmHg which noted to have a low diastolic pressure. …show more content…
During hospitalization the physician requested for B-type Natriuretic peptide level which later resulted as elevated at 828 (with unknown baseline) and a white blood cell count of 13.3 (no reference available at the time of the review). Suspected that some of the patient’s symptoms were due to acute bronchitis, he was started on Azithromycin daily which later switched to Doxycycline due to his prolonged QT at 522 ms. His home medication was resumed including Coreg, Lasix, Lisinopril, spironolactone and pravastatin with low dose of Aspirin. Along inpatient stay significant medication change was done including; Lisinopril that was decreased from 20 mg to 10 mg and Lasix decreased from 40 mg to 10 mg. In addition, Coreg and spironolactone were continued same as home doses of 12.5 mg twice a day and 50 mg daily respectively. Mr. U continuously complaints of left sided chest/rib pain which was thought due to pleurisy from infection. Discharge plan of care for him was to consume doxycycline for 5 days and regarding his low ejection fraction he must have cardiology appointment after 2 weeks and an outpatient medical follow up after 4
Initially, her blood pressure was 100/57 mmHg which noted to have a low diastolic pressure. …show more content…
During hospitalization the physician requested for B-type Natriuretic peptide level which later resulted as elevated at 828 (with unknown baseline) and a white blood cell count of 13.3 (no reference available at the time of the review). Suspected that some of the patient’s symptoms were due to acute bronchitis, he was started on Azithromycin daily which later switched to Doxycycline due to his prolonged QT at 522 ms. His home medication was resumed including Coreg, Lasix, Lisinopril, spironolactone and pravastatin with low dose of Aspirin. Along inpatient stay significant medication change was done including; Lisinopril that was decreased from 20 mg to 10 mg and Lasix decreased from 40 mg to 10 mg. In addition, Coreg and spironolactone were continued same as home doses of 12.5 mg twice a day and 50 mg daily respectively. Mr. U continuously complaints of left sided chest/rib pain which was thought due to pleurisy from infection. Discharge plan of care for him was to consume doxycycline for 5 days and regarding his low ejection fraction he must have cardiology appointment after 2 weeks and an outpatient medical follow up after 4