Dr. Demetriou refers Mr. Mason for an upper endoscopy and cultures. The next available appointment is in two weeks’ time. 

In the meantime, Mr. Mason is in a lot of discomfort and tries some of the new medication that you recommended. He finds that the antacid helps somewhat with alleviating his discomfort and decides to take it more frequently in the hope that he will get full relief. 

A few days later, Mr. Mason wakes up severely short-of-breath at 2am. He is cold, clammy and sweaty. Mrs. Mason takes him to the Emergency Department. Physical examination shows increased respiratory rate, elevated blood pressure and crackles are heard in his lungs. Mr. Mason receives appropriate treatment for his acute heart failure. 

Over the next few days, he feels better and he is discharged. He is advised to discuss use of his antacids with his physician as sodium salts can be particularly problematic for patients with heart failure. 

Please go back and re-consider your advice in regards to using antacids.