CASE HISTORY / EXAMINATION
A 61-year-old man with HF related to CHIC, complaining of gradual onset
of shortness of breath for 5 days, was admitted to our university
hospital for decompensated HF. He had been receiving multiple regimens
of chemotherapy, including anthracyclines for the treatment of lymphoma,
for 2 years. At the time of his admission, the lymphoma was in
remission, but his cardiac function had gradually declined from the
normal limit of left ventricular ejection fraction (LVEF) of 60.0% at
baseline. This hospitalization for HF was the third in the previous 10
months.
On admission, his blood pressure was 96/64 mmHg, pulse rate 118 /min,
body temperature 36.0 °C, and oxygen saturation 92% on room air, which
increased to 98% with 4 L/min cannula oxygen supply. Physical
examination revealed an engorged jugular vein, tachycardia with a grade
II systolic murmur over the apex, rales in both lower lung fields, and
bilateral edema in the lower extremities.