A frail woman in her 90s with chronic systolic heart failure, nonischemic cardiomyopathy, atrial fibrillation with left bundle branch block (LBBB), stage 3 chronic kidney disease, history of bladder cancer, and multiple mechanical falls within the past year presented to our hospital with a 5-day history of progressive dyspnea and resting chest pain. During the past 4 years, her heart failure had been managed with stable doses of metoprolol succinate, lisinopril, and furosemide. Physical examination revealed diffuse crackling in the lungs bilaterally.
Baker M, Weidendorf D, Swaminathan L. Cardiac Resynchronization Therapy—Does One Size Fit All? A Teachable Moment. JAMA Intern Med. 2017;177(10):1513–1514. doi:10.1001/jamainternmed.2017.2778
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