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Perspectives | Less Is More

Pulmonary Artery Rupture From Invasive Hemodynamic Monitoring

Ehrin J. Armstrong, MD; James M. McCabe, MD; Melvin D. Cheitlin, MD
Arch Intern Med. 2011;171(12):1109. doi:10.1001/archinternmed.2011.250.
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A 72-year-old man with systolic heart failure (left ventricular ejection fraction, 20%) and hypertension was admitted to the hospital with 2 weeks of dyspnea at rest and a 20-lb weight gain. He reported good compliance with his outpatient regimen of lisinopril, carvedilol, spironolactone, and furosemide. Findings from physical examination were notable for a blood pressure of 95/40 mm Hg and heart rate of 105 beats/min, elevated jugular venous pressure, diffuse crackles in the lung fields, an S3 gallop, and warm extremities. The patient was admitted to the cardiac intensive care unit and administered intravenous furosemide, with a net diuresis of 2 L overnight.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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