A 54-Year-Old Man Comes to the Emergency Department Due to Worsening

question 792

Multiple Choice

A 54-year-old man comes to the emergency department due to worsening shortness of breath for the last 3 days.  His symptoms initially occurred with exertion but are now present at rest.  The patient could not sleep last night because of a suffocating cough each time he tried to lie down.  He considers himself generally healthy and states, "I've never had to see a doctor for any problems."  Family history is remarkable for asthma and hypertension.  Blood pressure is 162/86 mm Hg, pulse is 92/min, and respirations are 26/min.  An x-ray of the chest is shown in the exhibit. 
Which of the following is the most likely diagnosis?

• A)Acute decompensated heart failure
• B)Acute respiratory distress syndrome
• C)Idiopathic pulmonary fibrosis
• D)Obstructive pulmonary disease
• E)Pulmonary arterial hypertension
• F)Tension pneumothorax

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