A 68-year-old woman comes to the office due to a history of progressive dyspnea, and dry cough. The patient has symptoms that worsen with exertion and when lying flat. She has had no chest pain, palpitations, or lightheadedness. The patient has a history of hypertension and breast cancer that is in remission after surgery and doxorubicin-based chemotherapy 15 years ago. She does not use tobacco, alcohol, or illicit drugs. Blood pressure is 110/62 mm Hg and pulse is 94/min. Physical examination shows crackles at the lung bases and bilateral pedal edema. Which of the following sets of findings are most likely present in this patient?

Question

A 68-year-old woman comes to the office due to a history of progressive dyspnea, and dry cough.  The patient has symptoms that worsen with exertion and when lying flat.  She has had no chest pain, palpitations, or lightheadedness.  The patient has a history of hypertension and breast cancer that is in remission after surgery and doxorubicin-based chemotherapy 15 years ago.  She does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 110/62 mm Hg and pulse is 94/min.  Physical examination shows crackles at the lung bases and bilateral pedal edema.  Which of the following sets of findings are most likely present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Patients with decompensated heart failure have elevated left ventricular end-diastolic pressure and decreased cardiac output that is most often primarily due to left ventricular dysfunction.  Right atrial pressure (ie, central venous pressure) is also elevated in advanced heart failure due to volume overload; right-sided heart failure (most often occurring secondary to left-sided failure) can also contribute to elevated right atrial pressure.

A 68-Year-Old Woman Comes to the Office Due to a History