Dr Bufaed MRCP A 60-year-old man comes to the clinic for heart failure review. He is already taking adequate doses of furosemide, ramipril, bisoprolol and spironolactone. Over the past few months his heart failure has got so bad that he has been confined to the downstairs of his home and can only walk a few paces. On examination he has a blood pressure (BP) of 110/70 mmHg, significant bilateral crackles on auscultation and bilateral ankle oedema. His creatinine is 130 µmol/l, his ejection fraction is 29% and he has a QRS of 165 ms. What should you do next? A Arrange a single-chamber pacemaker B Arrange cardiac resynchronisation therapy C Implant a cardioverter/defibrillator D Increase his furosemide E Start digoxin
Posted on: Fri, 31 Jan 2014 15:46:04 +0000
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