A 58-year-old man comes to the physician because of a 5-day history of progressively worsening shortness of breath and fatigue. The patient had a brief upper respiratory illness about a month ago but began experiencing progressive dyspnea on exertion 2 weeks ago. 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. he apical impulse is palpated in the sixth intercostal space along the left anterior axillary line. An S3 is heard on cardiac auscultation. Bibasilar crackles are present. Distal extremities are cold to touch and there is 1+ peripheral edema. Laboratory results are as follows: Which of the following is likely to be present in this patient compared to the normal state?

Question

A 58-year-old man comes to the physician because of a 5-day history of progressively worsening shortness of breath and fatigue. The patient had a brief upper respiratory illness about a month ago but began experiencing progressive dyspnea on exertion 2 weeks ago. 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. he apical impulse is palpated in the sixth intercostal space along the left anterior axillary line.  An S3 is heard on cardiac auscultation.  Bibasilar crackles are present.  Distal extremities are cold to touch and there is 1+ peripheral edema.  Laboratory results are as follows:  Which of the following is likely to be present in this patient compared to the normal state?

Quizplus · Accepted Answer

Eductional Objective: Cardiorenal syndrome is due to hemodynamic alterations related to a low cardiac output state and maladaptive neurohormonal changes.  Low cardiac output results in renal hypoperfusion, leading to activation of the renin-angiotensin-aldosterone system, antidiuretic hormone release, and increased sympathetic nervous system activity.  The resultant increase in sodium and water reabsorption and systemic vasoconstriction have detrimental effects on left ventricular systolic function, further worsening cardiac output and renal perfusion.

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