TY - CHAP M1 - Book, Section TI - Congestive Heart Failure A1 - Ginsberg, Fredric A1 - Parrillo, Joseph E. A2 - Lee, Kiwon PY - 2012 T2 - The NeuroICU Book AB - A 72-year-old woman is admitted to the intensive care unit (ICU) with a 9-hour history of left-sided weakness and tachypnea. She has had hypertension for over 15 years. There is no history of current chest pain or previous neurologic illness. Physical examination shows that she is awake and mildly lethargic. Pulse is regular at 80 bpm. Blood pressure is 210/110 mm Hg in both arms. Respiratory rate is 34 breaths/min. Temperature is 37°C. There is no pallor or jaundice. Jugular venous pressure is not elevated. Carotid pulses are brisk. Lungs show rales bilaterally. Cardiac examination shows normal heart tones without murmur. There is an S3 gallop. Abdomen is soft without mass. There is no peripheral edema. Neurologic examination shows the patient to be lethargic. There is a left hemiparesis.Laboratory shows normal complete blood cell count and chemistry profile. Serum B-natriuretic peptide (BNP) is elevated at 700 pg/mL. Serum troponin I is elevated at 0.10. Electrocardiogram (ECG) shows sinus rhythm with left ventricular hypertrophy and repolarization abnormality. Chest radiography shows cardiomegaly with signs of pulmonary edema. Emergency computed tomography scan of the head shows signs of acute right hemisphere ischemic infarction. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/10 UR - neurology.mhmedical.com/content.aspx?aid=1101644818 ER -