How do you approach the decision to use terlipressin in a patient with hepatorenal syndrome type 1, AKI, and a history of heart failure given its potential cardiovascular effects?  

I usually do a full workup to make sure the etiology of AKI is type 1 HRS. Would also make sure bleeding or infection not complicating the clinical scenario. This is not as simple as it seems, especially in the setting of primary heart failure as a complicating factor, and requires thorough thinking...