Last updated on: February 26th, 2024

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You’re looking at an interactive scenario from Clinical Sense (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.

Duncan II: Thumping


Not too long ago, you met 56-year-old Duncan, who presented with signs and symptoms of heart failure. He had an inferior NSTEMI one year before, which was treated with percutaneous coronary intervention and placement of a stent. He was also found to have hypertension and dyslipidemia at that time. Unfortunately, he defaulted treatment soon afterwards due to financial reasons.

Following careful investigation, you found Duncan to have NYHA class II heart failure with reduced ejection fraction (HFrEF). After educating and counseling him, you started him on the combination of furosemide and spironolactone for the heart failure, and nitroglycerin, carvedilol, aspirin, ticagrelor, valsartan, and atorvastatin for the ischemic heart disease. You also intended to start him on sodium-glucose co-transporter-2 inhibitors and angiotensin receptor-neprilysin inhibitors, costs permitting.

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