90-year-old man • dyspnea • lower extremity edema • limitations in daily activities • Dx?

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Heart failure with reduced ejection fraction (n=1). Intervention: Torsemide vs. Furosemide. Primary outcome: Clinical improvement (dyspnea, edema, NYHA class).

Paulus

doi:10.12788/jfp.0091

November 1, 2020The Journal of Family PracticeOpen Access

90-year-old man • dyspnea • lower extremity edema • limitations in daily activities • Dx?

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Why the study?

Does transitioning from furosemide to torsemide improve symptoms and fluid overload in a patient with HFrEF unresponsive to furosemide?

Study Design

Type

Case Report (n=1)

Structured PICO

Does transitioning from furosemide to torsemide improve symptoms and fluid overload in a patient with HFrEF unresponsive to furosemide?

P

Population

A 90-year-old man with NYHA Class III heart failure with reduced ejection fraction, unresponsive to furosemide, followed for 6 weeks after transitioning to torsemide.

I

Intervention

Torsemide 100 mg/d (replacing furosemide), along with initiation of lisinopril 2.5 mg/d and transition to metoprolol succinate 50 mg/d.

C

Comparator

Prior regimen of furosemide 80 mg/d and metoprolol tartrate 25 mg bid.

O

Outcome

Clinical improvement including symptom relief, weight loss, oxygen saturation, NYHA class, and BNP levels.patient reported

Limitations

Single case report limits generalizability
Additional prospective, head-to-head trials are needed to confirm torsemide's superiority over furosemide

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Implication

Transitioning from furosemide to torsemide may provide superior diuretic effect and symptom relief in patients with HFrEF who are unresponsive to furosemide.

Abstract

An obese 90-year-old White man presented for a 1-month follow-up with his family physician after being hospitalized for an acute exacerbation of heart failure (HF). In addition to New York Heart Association (NYHA) Class III heart failure with reduced ejection fraction (HFrEF), he had a history of tobacco abuse, hyperlipidemia, atrial fibrillation, coronary artery disease, stage 3 chronic kidney disease, and benign prostatic hyperplasia. The patient's family accompanied him during the visit to discuss hospice care.

Discussion

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Cite This Study

Paulus (2020) conducted a case report in Heart failure with reduced ejection fraction (n=1). Torsemide vs. Furosemide was evaluated on Clinical improvement (dyspnea, edema, NYHA class).

synapsesocial.com/papers/6a7c5f5460affc0860102f97 https://doi.org/10.12788/jfp.0091

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90-year-old man • dyspnea • lower extremity edema • limitations in daily activities • Dx?

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

90-year-old man • dyspnea • lower extremity edema • limitations in daily activities • Dx?

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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