Systolic Heart Failure

Ms. Boehmer has systolic heart failure. She has reported symptoms of dyspnea with exertions, orthopnea (evidenced by “sleeps on two pillows” at night), fatigue (evidenced by “she often feels tired”) and edema (evidenced by “reports that ankles are often swollen in the evening”) alterations in urination (evidenced by “nocturia X 2 and reports she sometimes has a strong urge to void and does not always make it to the toilet in time”). Physical examinations demonstrate S3 gallop. Cardiomegaly is present and cardiac output is decreased (evidenced by Echo result “mildly enlarged left atrium, ejection fraction 35%”). Other evidence includes a history of coronary artery disease and hypertension. (Brashers, 2012b). Diastolic heart failure is also