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A 56-Year-Old Man Comes to the Emergency Department Due to Progressively

question 236

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A 56-year-old man comes to the emergency department due to progressively worsening dyspnea.  The patient can walk only a few blocks before becoming short of breath.  He also finds it difficult to sleep lying flat and requires 3 pillows to prop himself upright when sleeping.  Other medical problems include long-standing hypertension, for which he occasionally takes his prescribed antihypertensive medication.  The patient does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 170/100 mm Hg, and pulse is 80/min and regular.  Physical examination reveals bilateral basilar lung crackles, jugular venous distension, and bilateral lower extremity edema.  Chest x-ray reveals cardiomegaly and hilar prominence.  ECG shows left ventricular hypertrophy.  Echocardiogram shows elevated pressures in the pulmonary artery.  Which of the following is the most likely underlying cause of the observed echocardiographic finding in this patient?

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Definitions:

Consigned Goods

Goods that are given to a third party to sell, but ownership remains with the supplier until sold.

Fiscal Period

A specific time frame used for accounting purposes, typically a year, over which a company reports its financial performance.

Freight

The charge paid for the transport of goods, usually based on the distance and weight of the merchandise being shipped.

Inventory Cost Flow

The process by which costs associated with inventory are accounted for, impacting how cost of goods sold and ending inventory are calculated.

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