A Case of Congestive Heart Failure with Gastrointestinal Bleeding and Altered Mental Status

Congestive heart failure (CHF) is a common cardiovascular condition associated with significant morbidity and mortality. Complications of CHF such as gastrointestinal bleeding and acute altered mental status pose diagnostic and therapeutic challenges. We present the case of a 75-year-old male with history of hypertension and coronary artery disease who presented with chest pain, vomiting, melena and decreased consciousness. Workup revealed anemia, elevated cardiac markers, evidence of congestive heart failure and subarachnoid hemorrhage. Clinicians should maintain a high index of suspicion for life-threatening complications in CHF patients presenting with atypical manifestations. Prompt diagnosis and optimization of underlying conditions are key to improving outcomes.