Elderly Female With Hypotension

An elderly woman with a history of heart failure with preserved ejection fraction, atrial fibrillation, hypertension, and aortic stenosis status post-transcatheter aortic valve replacement presented with new altered mental status and hypotension. Initial blood pressure was 87/50 mmHg, heart rate was 145 bpm, and respiratory rate was 30 bpm, and the patient had a temperature of 35.7°C. Her electrocardiogram showed atrial fibrillation with rapid ventricular response. Her infectious workup was consistent with urosepsis.