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Original Question

A 65-year-old white woman, Megan Hamilton, presents to the emergency department with orthopnea and paroxysmal nocturnal dyspnea in recent days; worsening dyspnea on exertion for the past few months and now dyspnea at rest; pedal edema; and with a history of dyslipidemia, type II diabetes mellitus, hypertension, coronary artery disease (status post 3-vessel bypass surgery two years ago). She denies any chest pain on exertion or at rest. She reports a history of osteoarthritis Intolerant to ACE inhibitors due to a cough No known drug allergies Amlodipine 2.5 mg each morning Losartan 100 mg each morning Enteric-coated aspirin 81 mg daily Rosuvastatin 20 mg each day Metformin 1 gram twice a day Ibuprofen 600 mg three times a day Nonsmoker Nonalcoholic Heart rate: 105 BPM Respiratory rate: 22 breaths per minute Blood pressure: 130/80 Room air oxygen saturation on pulse oximetry: 90% BMI: 25 Lungs: Diffuse crackles Heart: +S1, +S2 with regular rate and rhythm. No audible murmur. No extra heart sounds auscultated. Neck: Elevated jugular venous pressure Extremities: 2+ pitting edema Echocardiogram: Ejection fraction of 34% Chest x-ray: Diffuse vascular congestion. No pleural effusion. Electrocardiogram: Sinus tachycardia without evidence of acute ischemia; positive for left ventricular hypertrophy changes B-type natriuretic peptide level: Significantly elevated Troponin: Normal TSH: Normal Comprehensive metabolic profile: Normal values except for a non-fasting blood sugar of 250 mg/dl CBC: Normal Lipids: HDL cholesterol (HDL-C) 30 mg/dl; LDL cholesterol (LDL-C) 100 mg/dl; triglycerides (non-fasting) 400 mg/dl Hemoglobin A1C: 9.1 percent Review Section What initial therapy, care plan, and medications would you prescribe for this patient considering her current medications, acute presentation, and diagnoses? What are your rationales for each of these medications? What follow-up and monitoring are indicated, both acutely and long term, to manage her lipid disorder, diabetes mellitus, and heart failure with reduced ejection fraction?

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