TY - CHAP M1 - Book, Section TI - Acute Decompensated Heart Failure A1 - Titano, Ruwanthi A1 - Bietry, Raymond A1 - Pinney, Sean A2 - Lee, Kiwon Y1 - 2017 N1 - T2 - The NeuroICU Book, 2e AB - A 70-year old man with past medical history of coronary artery disease with previous percutaneous coronary intervention (PCI), systolic heart failure (ejection fraction, 40%), poorly controlled type II diabetes mellitus, hypertension, and hyperlipidemia is admitted to the neurosurgical intensive care unit after resection of a meningioma. He was doing well postoperatively until overnight, when he suddenly developed shortness of breath.The patient is found to be lethargic, tachypneic, tachycardic, and hypotensive with increased work of breathing. Cardiac examination reveals sinus tachycardia, S3 gallop, and an elevated jugular venous pulsation to the angle of the jaw. Bibasilar crackles are heard on lung auscultation. His lower extremities are cold and clammy with minimal pitting edema.ECG demonstrates sinus tachycardia with old Q waves in inferior leads and new ST segment depressions in leads V4-V6. Chest radiograph reveals marked pulmonary vascular congestion bilaterally with cephalization. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/09 UR - neurology.mhmedical.com/content.aspx?aid=1143956873 ER -