A 58-year-old man comes to the physician because of a 5-day history of progressively worsening shortness of breath and fatigue. He has smoked one pack of cigarettes daily for 30 years. His pulse is 96/min, respirations are 26/min, and blood pressure is 100/60 mm Hg. BMI is 30 kg/m². Oxygen saturation is 92% on room air. The apical impulse is palpated in the 6th intercostal space along the anterior axillary line. There is 3+ bilateral pitting edema in the legs. Which of the following is most likely increased in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Decreased cardiac output in heart failure triggers neuroendocrine compensatory mechanisms to maintain organ perfusion; however, the compensatory mechanisms are maladaptive over the long term.  Increased sympathetic output and activation of the renin-angiotensin-aldosterone system stimulate vasoconstriction and volume retention, compounding the hemodynamic stress on an already failing heart and creating a vicious cycle of decompensation.

A 58-Year-Old Man Comes to the Physician Because of a 5-Day