A 74-year-old man with known systolic heart failure presents with increasing dyspnoea, orthopnoea and peripheral oedema. On examination, he has elevat...

Question

A 74-year-old man with known systolic heart failure presents with increasing dyspnoea, orthopnoea and peripheral oedema. On examination, he has elevated JVP, bibasal crackles and pitting oedema. BP is 105/65 mmHg, SpO2 91% on room air. What is the most appropriate initial pharmacological treatment in the emergency department?

Accepted Answer

IV Frusemide and supplemental oxygen

Answer

High-dose IV beta-blocker

Answer

Large fluid bolus of 30 mL/kg normal saline

Answer

Commence ACE inhibitor only

Answer

Immediate thrombolysis

au-acem MCQ (SBA): Acute decompensated heart failure