Questions for Discussion:

1. What are the likely pathophysiologic mechanisms at work in this patient's heart failure? Answer
2. What ACC/AHA stage heart failure does this patient represent? What NHYA class?   Answer
3. What is the significance of the patient's blood pressure and how will it affect your management?  Answer
4. What tests, if any, are indicated? Answer
5. What changes, if any, would you make in the patient's diabetic drug therapy?  Answer
6. How do you treat her?  Answer
   • Discuss the use of ACE Inhibitors in this patient particularly with a focus on dosage.
   • Discuss the use of beta blockers in this diabetic patient with fluid overload.

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