3 Days Of Worsening in Medicine / Internal Medicine — 71yo Man | Cardiology | SMLE Q#11367

SMLE Question #11367

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 71-year-old man with chronic heart failure presents with 3 days of worsening dyspnea, orthopnea, and paroxysmal nocturnal dyspnea, with increasing leg swelling and abdominal fullness. Examination shows elevated jugular venous pressure, bilateral basal crackles, hepatomegaly, and bilateral pitting edema to the knees. He has no chest pain and is alert and oriented. What is the most appropriate next step in management?

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