Mr. A., a 67 year old African American male is here at the clinic for medication refill and annual physical exam. He doesn't remember all of his meds since he didn't write them down, but he remmbers taking St. John's Wort over the counter, ASA 81mg daily, Digoxin 0.125mg daily. He has a history of Rheumatic Heart Disease, Mitral valve replacement with mechanical device, and heart failure. He reported today that he has been feeling easily tired today. He has 2+ pitting edema in both legs. He also c/o pain when he walks but the pain subsides when he stopped working. The doctor just gave him an order for outpatient Chest xray. In the meantime, the doctor examined the patient and found the following: VS--96.8, 24, 66, 136/88, sats on RA--90%; crackles bilateral lower lobes, 2+ edema of the legs, abd tenderness, and dyspnea with exertion. Lower 1/3 of lower legs are shiny, cool to touch, and hairless w/ dark discoloration
5. What disease or new condition does he need to be worked up on. 5b. Which diagnostic test or lab should be ordered for this condition? 5d. What do you anticipate the treatment plan will be?
The condition is called congestive heart failure
There are multiple test for this but most specific and commonly used are Echocardiogram.Others like ECG, chest X-ray, spirometry, CT thorax, MRI thorax, Threadmill test can all can be used to clinch the diagnosis and monitor patient improvement
Medications
Surgery
Angioplasty
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