Questions for Discussion:

1. What factors may be contributing to this patient's apparent exacerbation of heart failure? Answer
2. What further diagnostic testing is indicated at this time? Answer
3. Is there an indication to admit this patient to the hospital for treatment at this time? Answer
4. How would you treat this patient's symptoms, is there a need for an adjustment in his present medication regimen?   What medications would you add or remove and why? Answer
5. List the medications that improve mortality in patients with LV dysfunction and CHF.   If you were forced to pick on medication to treat chronic heart failure based on evidence, which one would provide the greatest survival advantage? Answer
6. What are the contraindictions for starting B-blocker therapy in patients with CHF? Answer

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