ACE and pulmonary vascular congestion: Even when the contribution of HF to admission was uncertain, 41% were reported to have moderate-to-severe LVSD, 25% moderate-to-severe mitral regurgitation, 61% cardiomegaly or pulmonary congestion on a chest X-ray, 74% were prescribed loop diuretics, 60% an ACE inhibitor or angiotensin receptor blocker, and 38% a beta-blocker (Table 2), making a diagnosis of heart failure likely in many cases.