Question

A 58-year-old Aboriginal man with long-standing type 2 diabetes, obesity and smoking presents with increasing shortness of breath on exertion and orthopnoea. He lives 300 km from the nearest tertiary hospital. On examination, he has bilateral basal crackles and pitting oedema to the knees. What is the most appropriate initial management in his local rural hospital?

Accepted Answer

Start oral frusemide, optimise ACE inhibitor therapy and arrange early telehealth cardiology review

Answer

Discharge home and organise outpatient echocardiogram in 3 months

Answer

Wait for transfer to tertiary centre before starting any treatment

Answer

Start fluid restriction only

Answer

Stop all cardiovascular medications until specialist review

Practice question