Question

A 68-year-old man with known HFrEF (LVEF 30%) presents with acute worsening dyspnoea, orthopnoea and bilateral basal crackles. He is hypertensive at 170/100 mmHg, tachycardic 110 beats/min and has oxygen saturation 90% on room air. There are no signs of shock. According to Australian practice, what is the most appropriate immediate management in the emergency department?

Accepted Answer

Administer high-flow oxygen, intravenous frusemide and consider intravenous nitrates

Answer

Large fluid bolus of normal saline and observe

Answer

Increase his oral ACE inhibitor dose and discharge

Answer

Start oral beta blocker immediately at a higher dose

Answer

Arrange urgent intubation and mechanical ventilation in all acute heart failure cases

Practice question