A 74-year-old woman has symptoms of shortness of breath on exertion and waking up at night. Her physical examination reveals a JVP at 8 cm, extra third heart sound, lung crackles, and pedal edema. She is started on furosemide 80 mg/day for heart failure, while further investigations are performed.For the above patient with new symptoms, select the most likely acid base disorder.
Correct Answer: metabolic alkalosis
Description: Diuretics are a common cause of metabolic alkalosis. The disorder can occur in volume expanded patients in whom the alkalosis is unresponsive to sodium chloride loading, as in primary hyperaldosteronism or volume contraction with secondary hyperaldosteronism, as in this case.
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