Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with established diagnosis of HFpEF (Stage C), reporting progressive exertional dyspnea (NYHA Class [I-IV]), orthopnea, and paroxysmal nocturnal dyspnea. Current symptoms include [peripheral edema/fatigue/exercise intolerance]. Patient remains symptomatic despite optimized medical therapy. No recent hospitalizations for acute decompensated heart failure. Adherence to low-sodium diet and fluid restriction is [reported/suboptimal].
Clinical Examination Findings
General: Patient appears [non-distressed/mildly dyspneic] at rest. Vitals: BP [120/80], HR [75 bpm], O2 sat [96% on RA]. CV: Regular rate and rhythm, S1/S2 present, S4 gallop noted, no audible murmurs. JVP is [elevated/normal] at [X] cm above sternal angle. Lungs: [Clear to auscultation/bibasilar crackles]. Extremities: [1+/2+] pitting edema noted in bilateral lower extremities.
Treatment Protocol
Plan: 1. Optimize guideline-directed medical therapy (GDMT) for HFpEF, including SGLT2 inhibitors. 2. Titrate diuretics (e.g., Furosemide) to maintain euvolemia. 3. Aggressive management of comorbidities: Hypertension (target <130/80), Atrial Fibrillation (rate/rhythm control), and obesity. 4. Monitor electrolytes and renal function. 5. Referral to cardiac rehabilitation.