A 60-year-old male with a history of CHD presents with fatigue, shortness of breath, and swollen legs. On examination, his jugular venous pressure is elevated, and there is pitting edema in his legs. What could be the diagnosis and the next steps?
These symptoms and signs are indicative of heart failure, which is a complication of CHD. The next steps should be to confirm the diagnosis using an echocardiogram to assess the heart's structure and function, along with blood tests for BNP or NT-proBNP levels. Treatment should be initiated according to the current heart failure guidelines, which may include diuretics, ACE inhibitors or ARBs, beta-blockers, and possibly other medications.