John Craig

Emergency Department

A 70-year-old man with known chronic heart failure presents with 2 days of rapidly worsening breathlessness, now at rest, with orthopnea and a sensation of drowning. Working diagnosis is acute pulmonary oedema from decompensated heart failure, precipitated by medication non-compliance and a week of heavy alcohol intake; acute coronary, pulmonary embolic and other causes of acute dyspnoea must be excluded.

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Data Gathering

Take a comprehensive history, perform examinations, and order investigations.

Clinical Reasoning

Formulate a diagnosis, consider differentials, and synthesise evidence.

Clinical Decision Making

Explain your diagnosis, recommend treatment, and arrange follow-up.

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