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A 35-year-old female presents with intermittent right arm pain and numbness that has been worsening for the last month. Symptoms are worsened by lifting her arm above her head. She has also noticed new hand swelling and a “cold” sensation in her fingertips. On exam, she has diminished sensation in
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Acute heart failure exacerbation disposition
Not all patients require admission
Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up
Elevated troponin and serum Cr associated with worse outcomes
Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)
