An 81-year-old female with a history of HFrEF is admitted to…

An 81-year-old female with a history of HFrEF is admitted to the CCU for hemodynamic monitoring with a swan-ganz catheter. She is on a dobutamine infusion at 5 mcg/kg/min but continues to have poor cardiac output. In order to know if she would benefit from afterload reduction the SVR needs to be calculated. Calculation of the systemic vascular resistance (SVR) requires all of the following except?

A 26-year-old woman with no prior medical history presents t…

A 26-year-old woman with no prior medical history presents to the emergency department (ED) with progressively worsening dyspnea for 1 week. Her symptoms are preceded by 3 days of fever, rigors, and nasal congestion. She is afebrile with HR of 116 beats/min and BP of 92/70 mmHg. Physical examination reveals bilateral rales, elevated jugular venous pressure, 2/6 systolic murmur at the left lower sternal border, cool extremities, and 2+ bilateral lower extremity edema. Echocardiogram reveals LVEF of 20%, nondilated LV (LV end-diastolic diameter of 3.4 cm), global hypokinesis, mild mitral regurgitation, and a normal right ventricular function. Labs are significant for creatinine of 1.6 mg/dL, aspartate aminotransferase (AST) of 385 U/L, alanine aminotransferase (ALT) of 413 U/L, troponin I of 4.8 ng/mL, and serum lactic acid of 2.8 mmol/L. Intravenous diuretics and dobutamine are initiated. Within 24 hours of admission, the patient develops hypotension and worsening heart failure refractory to inotropes and vasopressors. Urine output is 125 cc in the last 6 hours.  Which of the following is the best next step in her management to stabilize her?

A 65-year-old male patient is post-MI. Before the event, the…

A 65-year-old male patient is post-MI. Before the event, the patient had a history of hyperlipidemia but was not on any pharmacotherapy. The patient is started on beta blocker and statin therapy. Upon a chart review, you note the patient is consistently hypertensive and has a left ventricular ejection fraction (LVEF) of 40%. Which of the following medication classes would be most appropriate to add for this patient?