A 65-year-old male with a history of heart failure reports awakening from sleep with shortness of breath. He also reports orthopnea. Physical examination reveals bilateral ankle edema. What could be the potential cause and how would you manage this case?
This patient's symptoms suggest Paroxysmal Nocturnal Dyspnea (PND), which can occur in conditions like heart failure. PND can be mistaken for sleep apnea due to similar nocturnal symptoms. Management would focus on treating the underlying heart failure - optimizing diuretic therapy, managing fluid balance, and adjusting other heart failure medications as needed. A consultation with a cardiologist may also be helpful.