Clinical Decision Support
Patient Information
Current case under review
- Full name
- Michael Johnson
- Age / DOB
- 64 years / 05/12/1961
- Current complaint
- Progressive dyspnea on exertion, fatigue, peripheral edema
- Key history
- HTN Type 2 DM CAD COPD Prior MI (2020)
AI-Generated Differential Diagnosis
DEfRAG Analysis CompleteCongestive Heart Failure
87%Key supporting findings:
- BNP elevated at 825 pg/mL (measured today)
- Ejection fraction 35% on recent echo
- Bilateral crackles on lung exam
- JVD and peripheral edema present
COPD Exacerbation
42%Key supporting findings:
- History of COPD with recent albuterol use increase
- Decreased breath sounds bilaterally
Pulmonary Embolism
23%Key supporting findings:
- D-dimer slightly elevated at 0.65 μg/mL
- Wells score: 3.0 (moderate risk)
AI Clinical Reasoning
The constellation of symptoms including peripheral edema, elevated BNP, reduced ejection fraction, and pulmonary congestion strongly favor CHF as the primary diagnosis. While the patient's COPD history is relevant, the cardiac biomarkers and imaging suggest heart failure is the predominant issue requiring immediate management.
Similar Patient Cases
AI-identified cases with comparable presentations
Case #12089
67M, similar comorbidities
Treated with diuretics and ACE inhibitors with good response within 72 hours.
Case #08734
59M, post-MI CHF
Required BiPAP support initially, responded to aggressive diuresis.
Case #15422
70M, CHF with renal impairment
Careful diuresis with renal monitoring led to successful outcome.
AI Treatment Recommendations
Updated 5 minutes agoPrimary Intervention
IV Furosemide
40mg IV push now, then 40mg IV q12h
ACE Inhibitor
Lisinopril 5mg PO daily
Beta Blocker
Carvedilol 3.125mg PO BID
Additional Considerations
Oxygen Therapy
Supplemental O2 to maintain SpO2 > 92%
Sodium Restriction
Limit to < 2g/day
Daily Weight Monitoring
Track fluid status with daily morning weights
Contraindication Analysis
Caution with ACE Inhibitors
Patient's most recent creatinine is 1.4 mg/dL. Start at low dose and monitor renal function in 48-72 hours.
Outcomes Prediction
Based on similar cases and current presentation, the AI model predicts:
- 89% probability of symptomatic improvement within 72 hours with recommended treatment
- Expected length of stay: 4-6 days
- 75% probability of maintaining stable outpatient status with adherence to recommended regimen
Evidence Explorer
Supporting clinical evidence for recommendations
2023 AHA/ACC Guidelines for HF Management
American Heart Association, American College of Cardiology
"Loop diuretics remain the cornerstone of congestion treatment in acute heart failure..."
Meta-analysis: ACE Inhibitors in Heart Failure
New England Journal of Medicine, 2022
"ACE inhibitors showed a 23% reduction in mortality across all studies analyzed (n=12,763)..."
Beta-blockers for Reduced EF Heart Failure
Journal of the American Medical Association, 2023
"Early initiation of beta-blockers was associated with improved long-term outcomes when carefully titrated..."
Interactive Decision Tree
AI reasoning pathway for current diagnostic and treatment recommendations
The decision tree shows how the AI analyzed 147 clinical variables from the patient record to arrive at the current recommendations, with each node representing a key decision point in the diagnostic and treatment pathway.
Suggested Specialists
AI-recommended experts for this case
Dr. James Wilson
Cardiology, Heart Failure Specialist
Dr. Maria Rodriguez
Pulmonology
Dr. Robert Chen
Nephrology