Case Study Of Congestive Heart Failure

The patient is an 88-year-old gentleman who initially presents to the ED because of a fall. The patient fell off a chair at home. He subsequently was found to be in some mild heart failure. The decision was made to admit the patient. The patient has a known history of diabetes, hypertension, hypercholesterolemia. He is also known to have a pacemaker in place and has some past history congestive heart failure. Laboratory works the patient indicates the patient has acute kidney injury, as well as being mildly anemic with hemoglobin on presentation of 11.6. He also has thrombocytopenia with a platelet count 79,000. Initial cardiac enzyme in the ED is 0.114 with a BNP of 714, however within several hours of admission the troponin level jumps to 0.243. The patient underwent a CT of the the chest, abdomen and pelvis. The chest reveals large right and moderate left pleural effusion, mild to moderate cardiomegaly bilateral lower lobe compressive atelectasis associated with diffuse groundglass opacification lungs suggesting congestive failure. The abdomen reveals mild anasarca trace ascites consistent with right heart failure and also a fecal impaction.
The patient requires acute inpatient hospitalization for aggressive treatment and