Background: Acute decompensated heart failure exacerbation is the leading cause of hospitalization in the United States. It was associated with total medical costs of more than $30 billion in 2012 with projections estimating around $70 billion in costs by 2030. Currently, six million people in the U.S. have heart failure, with a little over half [...]

Case Presentation: A 31 year old male with no known medical history presented to the hospital with complaints of acute onset chest pain, shortness of breath and 30 lb weight gain. History was notable for a period of starvation with intake of exogenous testosterone, T3 and growth hormone prior to a bodybuilding competition followed by [...]

Background: Acute Decompensated Heart Failure (ADHF) is responsible for over a million hospitalizations per year in the US and Europe. The American Heart Association Guidelines for treatment of patients hospitalized with ADHF recommend intravenous (IV) diuresis with loop diuretics to reduce fluid overload until vascular congestion is relieved. However, the optimal dosing strategy for IV [...]

Case Presentation: A 58-year-old male presented to the hospital with several days of fatigue and shortness of breath. His vitals were initially stable, and labs showed a hemoglobin of 4.2 (normal 13.5—17.5), white blood cell count WBC 20.1 (4.5—11.0), and platelet count 43 (160—420), BNP 617 (0—900 pg/ml). He received one unit of packed red [...]