Skill Checkup: A 73-Year-Old Man With History of Chronic Heart Failure Presents With Dyspnea, Rales, and Fluid Retention

Yasmine S. Ali, MD


February 16, 2022

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 73-year-old man presents with dyspnea, rales, and fluid retention. His height is 5 ft 9 in and weight is 160 lb (BMI, 23.6). The patient has a history of chronic heart failure (New York Heart Association class 2-4). Ejection fraction is < 40% and estimated glomerular filtration rate is ≥ 20 mL/min/1.73 m2. Physical examination is notable for distended veins in the neck and pallor. Hemoglobin level is 10.1 g/dL.


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