Problem
Rosemary Clayton is a 62-year-old female. She presents today with shortness of breath and increased swelling in her lower extremities. She reports having mild shortness of breath has been gradually increasing over the past 4 days. She notices that her shortness of breath increases when she is lying in bed at night, and has to prop her head up with two pillows in order to sleep. States she has had no exertional chest pain or heartburn. She takes Valsartan 160 mg po BID Furosemide 20 mg po once daily Atorvastatin 40 mg po once daily Aspirin 81 mg po once daily Multivitamin once daily
What pharmacologic therapy should be recommended to this patient for acute treatment of heart failure? What should be recommended for chronic management? Are there any medications you would discontinue? What non-pharmacologic therapy should be recommended? What follow-up care will be needed?