A 66-year-old man comes to the physician because of a 3-week history of shortness of breath with exertion. He has hypertension, hyperlipidemia, and type 2 diabetes mellitus. Current medications include aspirin, losartan, simvastatin, and insulin. His temperature is 37.1°C (98.8°F), pulse is 74/min, and blood pressure is 150/84 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96%. Physical examination shows bilateral lower extremity edema and distended neck veins. Cardiac auscultation findings over the apex are given below. This patient's auscultatory findings most likely reflect which of the following?

Question

A 66-year-old man comes to the physician because of a 3-week history of shortness of breath with exertion. He has hypertension, hyperlipidemia, and type 2 diabetes mellitus. Current medications include aspirin, losartan, simvastatin, and insulin. His temperature is 37.1°C (98.8°F), pulse is 74/min, and blood pressure is 150/84 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96%. Physical examination shows bilateral lower extremity edema and distended neck veins.  Cardiac auscultation findings over the apex are given below.  This patient's auscultatory findings most likely reflect which of the following?

Quizplus · Accepted Answer

Eductional Objective: An S3 is a low-frequency sound that occurs just after S2 and is typically associated with ventricular volume overload.  It is commonly heard in patients with mitral or aortic regurgitation or heart failure with reduced ejection fraction (eg, dilated cardiomyopathy).

A 66-Year-Old Man Comes to the Physician Because of a 3-Week