Background: The characteristic profiles of lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) individuals with heart failure are scarce in the literature. This investigation analyzes the demographics of LGBTQ individuals with heart failure and appropriateness of medical therapy. Methods: A multi-center retrospective analysis of LGBTQ individuals with a diagnosis of heart failure was conducted […]

Background: Heart failure is expected to increase in prevalence globally.(1) The increased incidence of metabolic disorders coupled with the increase in life expectancy in Singapore has contributed to this trend. Heart failure poses a great burden on patients, caregivers and the healthcare system.Previous European studies have suggested that patients managed by internists differ in baseline […]

Background: Serum levels of pro-B-type natriuretic peptide (BNP) and N-terminal (NT) proBNP are measured at admission to assess likelihood of acutely decompensated heart failure (ADHF). Pro-BNP, released by myocardium due to cardiac wall distention, is cleaved into the active BNP and inactive NT-proBNP forms. Elevated NT-proBNP levels on initial presentation are a reliable marker of […]

Background: Heart failure (HF) is a common, chronic clinical syndrome often accompanied by episodes of acute decompensation driven by volume overload (1). Reversing this overloaded state is the principal goal in treatment of acute decompensated HF, typically achieved using loop diuretics (2). Despite ubiquitous use of loop diuretics, guidance on initial dosing strategies remains limited […]

Background: Heart failure (HF) is a major contributor to hospitalizations. At our institution, we determined that the average length of stay (LOS) for HF admissions was 0.54 days longer than expected compared to similar hospitals nationwide based on a risk-adjusted methodology. A chart review (n=25 patients) revealed that LOS was often extended due to ongoing […]

Background: Heart Failure (HF) is an important health care issue given its high prevalence, mortality, and cost of care. By 2030, greater than 8 million Americans will be living with HF. The projected cost will increase to close to 70 billion with the majority of the cost attributed to hospitalization. Despite numerous evidence-based strategies in […]

Case Presentation: A 40-year-old woman with a history of anxiety presented with one week of diffuse abdominal pain, associated with constipation, decreased oral intake, nausea, and bilious emesis three times a day. She was admitted to an outside hospital one month prior with similar symptoms and treated for pneumonia. The patient lives alone and denied […]

Case Presentation: 66-year-old man with recent diagnosis of heart failure with preserved ejection fraction, atrial fibrillation, and chronic kidney disease presented with worsening shortness of breath. On presentation, he had crackles in the left lower lobe, 1+ pitting edema, and macroglossia. BNP 17,371and creatinine 2.88 (baseline of 2.4). Chest x-ray: mild pulmonary vascular congestion, trace […]

Case Presentation: A 31-year-old male with a past medical history of dilated cardiomyopathy (ejection fraction 20%) presented with shortness of breath. Initial blood pressure was 83/53 mmHg. His breathing became agonal and therefore he was intubated. Physical examination demonstrated jugular venous distention and cold extremities. Chest radiography (Figure 1) revealed diffuse and complete opacification of […]

Case Presentation: A 22-year-old man with recent diagnosis of COVID-19 after developing shortness of breath was admitted to our hospital on day 5 of symptoms with acute worsening of dyspnea and new onset chest pain. On admission, he was tachycardic to the 120s, febrile to 38.6°C and hypotensive with systolic pressures in the 80s. On […]