Outpatient C: Ongoing Assessment of HF

Patient:	64 y/o male; presents to the HF clinic for routine monthly visit. Current status is good. No issues performing daily activities.
History:	Patient diagnosed with HF 2 years ago after presenting to the ED with acute exacerbation. Patient is being treated with ACE inhibitor and beta blocker and is well-controlled. Diuretics are used when needed.

Physical Examination

VS:	Temp 98.6, O2 Sat 98%, BP 138/95
Neck:	No jugular vein distension
Ext:	Warm & dry
CV:	Regular heart rate and rhythm
Current Meds:	Lisinopril and metoprolol-XL
Baseline BNP value:	357 pg/mL

Disposition: BNP test ordered to assess patient in conjunction with physical exam. BNP level was 1015 pg/mL, which, when evaluated in conjunction with other clinical information available to the physcian, indicates that the patient’s HF was worsening. Aggressive IV diuretics ordered. Patient discharged with electrolyte replacement therapy and lasix. Patient scheduled for 48-hour follow-up visit.