A 62-year-old white male comes to your outpatient clinic with a complaint of worsening symptoms of heart failure (increased shortness of breath, edema, weight gain, orthopnea, and tiredness). The patient is currently on enalapril 5 mg bid, metoprolol succinate 25mg bid, and furosemide 80mg qd. There is no history of renal impairment. Blood pressure is 120/80 mmHg, and heart rate is 69 bpm.
The same patient returns to the clinic 6 months later and is feeling great. He is currently on enalapril 5 mg bid, metoprolol succinate 25mg bid, furosemide 80mg qd (no history of renal impairment). His blood pressure is 120/80 mmH and heart rate is 69 bpm.