How should a 78-year-old woman with diastolic heart failure, hypertension, and an LVEF of 70% be treated?
A clinical vignette presenting a case of a 78-year-old woman with hypertensive diastolic heart failure to discuss treatment strategies.
A 78-year-old woman with a history of hypertension is admitted to the hospital with congestive heart failure. Physical examination reveals a blood pressure of 180/90 mm Hg, increased jugular venous pressure, peripheral edema, and pulmonary rales. A chest radiograph shows pulmonary edema and mild cardiomegaly. An echocardiogram shows a left ventricular ejection fraction of 70 percent. The left ventricular Doppler filling pattern is abnormal and consistent with an elevated pulmonary-capillary wedge pressure. How should this patient be treated?
Aurigemma et al. (Wed,) studied this question.