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Symptoms and Complication of Heart Failure Essay

Question

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M., a man who has been coming to the clinic for several years for management of coronary artery disease (CAD) and hypertension (HTN). A cardiac catheterization done a year ago showed $50\%$ stenosis of the circurnflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a chest $x$-ray (CXR) examination revealed cardiomegaly, and a 12-lead electrocardiogram (ECG) showed sinus tachycardia with left bundle branch block (LBBB). You review J.M.'s morning blood work and initial assessment. Chart View Initial Assessment Complains of increased fatigue and shortness of breath, especially with activity, and "waking up gasping for breath" at night, for the past 2 days. 1. Indicate whether J.M.'s vital signs are normal or abnormal, indicate normal ranges, and explain your rationale for the change in Vital Signs. 2. As you review these results, which ones are of possible concern, and why?