USOM I Case 2

64 y/o M with pmhx of CAD, prior PCI, presents with increasing dyspnea on exertion, fatigue, paroxysmal nocturnal dyspnea, and weight gain.  Over the last two days he has developed confusion and weakness.

You perform a bedside ultrasound, which reveals the following: Case 2 Ultrasound

What is the diagnosis and what ultrasound findings support this?

The lab calls to report a critical value on the patient’s vbg (corroborated on bmp) of a Na+ of 112 (new compared to prior labs)

What type of hyponatremia does this patient have (question 1 of case 1 lists a few of the possibilities)?  How do you want to do to treat the patient’s hyponatremia?