Medical History A 72-year-old male was admitted to the hospital after presenting with chest pain, progressive dyspnea, nausea and peripheral edema. Physical examination demonstrated adequate blood pressure levels and peripheral perfusion. Electrocardiography did not indicate any acute abnormality, and troponin levels were normal. Transthoracic echocardiography showed left ventricular ejection fraction of 42%, left ventricle segmental contractility alterations and mild systolic dysfunction. Previous history of two myocardial infarctions without ST elevation and right coronary angioplasty. Chest radiograph was performed. Chest radiograph, posteroanterior view.Chest radiograph, lateral view. Question:Considering the previous history and the current clinical-hemodynamic repercussions, what is the most appropriate therapeutic approach? Intravenous vasodilator and diuretics Vasodilator, diuretics, inotropic/vasopressor agents and intensive care support Fluid replacement and inotropic agents Angioplasty Test Question UDI HOSPITAL – MA (2017) Which are the main precipitating factors of cardiac decompensation in chronic hypertensive heart failure? Progressive cardiomyopathy and right ventricle infarction Infection and nonadherence to diuretics and vasodilator therapy Pericarditis and chronic systemic inflammation Anemia and myocardial infarction Acute myocarditis and worsening of myocardial ischemia Time is Up! Time's up
