A 69-year-old woman presents to her primary care physician complaining of increasing shortness of breath, especially when trying to sleep. She has a history of hypertension and hyperlipidemia and is being treated with a beta-blocker and statin therapy. She does not smoke and drinks alcohol in moderation. On examination, her blood pressure is 148/83 mmHg and heart rate are 126 bpm. There is an audible S4 and the jugular venous pressure (JVP) is elevated 3 cm above normal. 1. Give 1 primary diagnosis with rationale and 3 differential diagnoses and rationale. (3 points) 2. How would you work-up the patient? What is the patients New York Heart Association (NYHA) classification? (2 points) 3. Give the nonpharmacologic and pharmacologic treatment of your primary diagnosis. (3 points) 4. Two references not more than 5 years old. One reference should be from the course reference books and the other is from a peer reviewed journal or guidelines. Respond to one classmate using evidence-based reference (peer reviewed journal or guidelines). (2 points)
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