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Teachable Moment
Less Is More
October 2017

Cardiac Resynchronization Therapy—Does One Size Fit All?A Teachable Moment

Author Affiliations
  • 1Medical student at Wayne State University School of Medicine, Detroit, Michigan
  • 2Department of Internal Medicine, Beaumont Hospital, Dearborn, Michigan
JAMA Intern Med. 2017;177(10):1513-1514. doi:10.1001/jamainternmed.2017.2778

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.

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