
Suggest Treatment For CHF

I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Seems that the patient has several cardiac disorders (ischemic, arrhythmic, CHF) addressed by the underlying therapy, as well as other extra-cardiac pathologies (thyroid, anemia, pulmonary, depression, etc.)
She is taking almost all the necessary drugs for her underlying cardiac conditions (arrhythmia - amiodarone; CHF - zaroxoly, lasix; cardiac ischemia - aspirin, imdur) and for extra-cardiac issues as well.
As she is in good mental health and shows a satisfactory daily attitude, it can be concluded that her actual therapy is doing fairly well.
Nevertheless, I would like to explain that in a CHF patient it is very important to carefully consider every co-morbidity (which she seems to suffer already), as they may be a trigger for heart failure decompensation.
So, an acute pulmonary infection, anemia aggravation, a thyroid gland disequilibrium, but also a paroxysmal cardiac arrhythmia, a new myocardial ischemia onset, an extreme blood pressure fluctuation, etc. may lead to serious adverse implication on her CHF status.
I would recommend a close blood pressure and heart rate monitoring to prevent any potential inconvenience, periodically (1-2 months) check her blood electrolytes (she is taking diuretics and also anti-arrhythmics), thyroid, renal and liver function tests, a complete blood count (for screening anemia), PCR for any possible inflammation, etc.
It is also important to perform a periodic physical exam by her attending physician and a clinical status review for assuring the therapy is doing well and no superimposed disorder is adversely influencing her actual status.
Hope to have been helpful to you!
Feel free to ask me whenever you need!
Greetings!
Dr. Iliri

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