Vital signs including heart rate, temperature, and blood pressure, and oxygen saturation should be done at regular intervals. Diagnostic tests include a 12 lead ECG, the cardiac biomarkers of CPK with isoenzymes, troponin T or I, high sensitivity C-reactive protein, CBC, erythrocyte sedimentation rate, serum electrolytes, BUN and serum creatinine. Perform a complete heart and lung exam. Assess peripheral pulses, and assess extremities for edema, cyanosis, and clubbing. Echocardiography should be ordered. This is the gold standard in diagnosing wall motion abnormalities, ventricular function, valvular or septal defects, and ejection fractions (Mcconaghy, & Oza, 2013). 1st line therapeutic interventions, patient education and follow up expectations
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