Skill Checkup: A 54-Year-Old Black Man With Treated Heart Failure Has Worsening Symptoms

Jeffrey J. Hsu, MD


November 16, 2023

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

A 54-year-old Black man in the United States presents for a routine follow-up in the cardiology clinic with a history of heart failure (HF) diagnosed 3 years ago. At the time of his initial diagnosis, the patient's cardiac function was characterized by a left ventricular ejection fraction (LVEF) of 47%. He has since been managed with a regimen adhering strictly to current HF guidelines, which includes the use of antihypertensive medications and diuretics. Despite this, he reports a gradual increase in symptoms over the past several months, including worsening exertional dyspnea and occasional nocturnal cough. Objective assessment today reveals an LVEF of 42%, along with clinical signs suggestive of congestive HF, such as elevated jugular venous pressure and peripheral edema.


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