Published on: July 2023 

Indian Journal of Pharmacy Practice,2023; 16(3):264-266    

Case Report  | doi :10.5530/ijopp.16.4.45  

Prakash Nathaniel Kumar Sarella1,*, Harshika Gudapati2 , Patrick Oliver Asogwa1 , Ravishankar Kakarparthy1

1Department of Pharmacology, Aditya College of Pharmacy, Surampalem, Kakinada, Andhra Pradesh, INDIA.

2Department of Pharmacy Practice, Government General Hospital, Kakinada, Andhra Pradesh, INDIA.


Heart failure in elderly patients often presents with atypical manifestations due to the high prevalence of comorbid conditions. Symptoms may be subtle and under-reported. Timely diagnosis of heart failure and treatment of comorbidities are crucial for effective management. We describe a 75-year-old female with a history of similar complaints who presented with pedal edema, shortness of breath, and fatigue. Investigations revealed atrial fibrillation, severely reduced left ventricular function, and increased forearm vascular resistance suggesting peripheral vascular disease. Laboratory tests showed decreased uridine diphosphate levels. This case highlights the diagnostic challenges of heart failure in elderly patients with multiple comorbidities. Atypical presentations are common and timely recognition of underlying heart failure is needed to optimize management and prevent exacerbations. Treatment of comorbid conditions like atrial fibrillation and peripheral vascular disease may also help improve outcomes.

Keywords: Comorbidity, Differential Diagnosis, Elderly patients, Heart failure, Multiple coronary disease.