cardio - nithiatr

[ArchivalUser]

68 yr old man with h/o bacterial endocarditis presents with SOB,history related to orthopnea and PND.o/e hez comfortable at rest.no JVD and pedal edema.scattered wheezes throout both lung fields.PSM heard at apex radiating to axilla.EKG normal.ECHO shows ejection fraction of 55%.what is the next best step?
1)digoxin
2)enalapril
3)HCTZ
4)valve replacement
5)warfarin
6)metoprolol
7)heart transplant

[ArchivalUser]

3.

[ArchivalUser]

itz not the answer

[ArchivalUser]

Valve replacement because Worsening Mitral regurgitation -- In MR > If EF less than 60% AND LVESD more than 45 mm---time to replace the valve.

[ArchivalUser]

1 OR 2???

[ArchivalUser]

you are right drvirgo

[ArchivalUser]

44

[ArchivalUser]

best treatment is Vavle replacement..............................but.............think this pt came to er...........what will er doc will do................he will treat chf First than will consult cardiologist.......In between he will treat CHF first.....................so what u think now?

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