[CK] Dobutamine vs Mildirnone.

Recommendations:
- Dobutamine drip at 3 mcg/kg/min with significant symptomatic improvement but HR up to 140-150s, dose reduced to 2 mcg/kg/min
- She does not have current peripheral eosinophilia and her h/o eos is not related to dobutamine infusion.  Milrinone would likely result in further peripheral vasodilation and hypotension.
- increase lasix drip to 15 mg/hr, gove lasix bolus 80 mg x 1
- restart heparin drip without a bolus, with PTT target 70-90
- not using nomogram, physician directed with PTT check every 6 hours until stable dose
- Acetylcysteine drip started on 10/29
- I dicussed with hepatology today, recommended to continue until ALT<1000 and INR < 1.5, or d/c after 7 days of treatment => d/c 11/5/18
- f/u blood cx, urinalysis/cx
- defer other GDMT until diuresed and BP stable
- would attempt DCCV again when euvolemic
- once patient is adequately rate controlled, consider stress cardiac MRI for evaluation of myocardial inflammation, r/o ischemic disease.
- labs at 18:00 today: H&H, PTT, BMP