Question

A 72-year-old woman is admitted with shortness of breath at rest, orthopnoea and frothy pink sputum. She has a history of hypertension and is on Ramipril. On examination she is tachypnoeic, has bilateral basal crackles and a blood pressure of 180/100 mmHg. What is the most appropriate immediate management step in the emergency department?

Accepted Answer

Sit her upright, give high-flow oxygen, intravenous Frusemide and sublingual Nitrate

Answer

Start high-dose intravenous Frusemide and titrate slowly over 24 hours

Answer

Give a fluid bolus of 500 mL 0.9 percent saline over 15 minutes

Answer

Arrange urgent outpatient echocardiography and start oral ACE inhibitor

Answer

Start beta blocker therapy immediately to slow the heart rate

Practice question