21st February 2024

A 65-year-old gentleman presented to A&E with acute onset shortness of breath, productive cough with frothy sputum and chest pain

A 65-year-old gentleman presented to A&E with acute onset shortness of breath, productive cough with frothy sputum and chest pain. The patient explained experiencing shortness of breath at night when sleeping and having to use 3-4 pillows at night. On examination, there was a raised JVP and peripheral oedema in the legs. His past medical history includes hypertension which is treated with Ramipril, type 2 diabetes which is treated with Metformin and 2 previous STEMIs. He does not have any known drug allergies. His bloods were reported below. A chest x-ray was performed which revealed cardiomegaly and bilateral pleural effusion. Bloods: BNP – 1590 (elevated), Troponin – negative, CKMB – negative. Prescribe one drug that should be administered to the patient immediately to improve the patient’s shortness of breath.