Background: Heart failure (HF) and atrial fibrillation (AF) share several risk factors including coronary artery disease, hypertension, smoking, obesity, diabetes, and renal disease, as well as common pathophysiologic pathway involving activation of the renin–angiotensin–aldosterone system, maladaptive atrial remodeling and subsequent impaired conduction system. Some studies have supported the role of angiotensin converting enzyme inhibitors (ACEIs) [...]

Case Presentation: A 46-year-old female presented for evaluation of two days of nausea and vomiting. She also described swelling in her legs and decreased urination over that time. Exam revealed blood pressure of 150/100 (baseline blood pressure 90/50), pitting lower extremity edema, taut skin of both hands, and bibasilar crackles. Labs revealed creatinine of 3.2 [...]