Should you discontinue beta-blockers in patients admitted for a CHF exacerbation currently taking a beta-blocker?

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Abstract

CASE

A 67-year-old man with a history of hypertension and heart failure presents to the emergency department with 3 days of progressively worsening dyspnea on exertion, mild nonproductive cough, increasing lower extremity edema, and orthopnea. ECG shows normal sinus rhythm with mild left ventricular hypertrophy, and chest radiography is significant for cardiomegaly with cephalization and bilateral pleural effusions. The intern inquires whether the patient's beta-blocker should be continued or withdrawn during this admission for an acute heart failure exacerbation.

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