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A 69 year old male presents to his physician’s office with a 3 week history of shortness of breath when climbing stairs. He sleeps with 3 pillows. He has been an insulin-dependent diabetic for 35 years. He has a 45 pack year history of cigarette smoking.

  • Describe the patient.
  • What is the chief complaint and differential diagnosis?
  • How long has the patient had heart disease?
  • How does the body regulate cardiac output?
  • Describe the pathophysiology of RV-CHF
  • Describe the clinical-pathologic correlation:
    • Symptoms
      • Swollen feet
      • RUQ discomfort
    • Signs
      • Pitting edema
      • Hepatomegaly with reflux
      • JVD
    • c) Testing
      • Laboratory
      • Imaging
      • Pulmonary artery diameter/pressure
  • Explain the findings to the patient