{"ops":[{"insert":"A 58-year-old woman presents with paroxysmal nocturnal dyspnea for 2 weeks, in a background of worsening exertional dyspnea, vague chest discomfort, and pitting peripheral edema for 1 year. There is no paroxsmal nocturnal dyspnea or orthopnea. Her New York Heart Association (NYHA) classification is II. \n \nHer surgical history is significant for two lower segment caesarean sections (LSCS) performed at the ages of 32 and 36 respectively. Her medical, drug, allergic, and family histories are all unremarkable. She does not smoke, only drinks socially, and does not use recreational drugs.\n \nHer basic bloodwork, including a complete blood count, serum electrolyte assay, and liver and renal profiles, are all within normal parameters.\n\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-264_en.png"}},{"insert":"\n"}]}
2
Investigate
Troponin I
{"ops":[{"insert":"You realize troponin levels are not required right now.\n"}]}
ECG
{"ops":[{"insert":"The ECG is in sinus rhythm, with a rate of 76 bpm. No morphologic abnormalities are noted.\n"}]}