p2
Forum Senior
Topics: 41
Posts: 52
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3. Over the past 2 weeks, a 60-year-old man has had shortness of breath on exertion. He also has paroxysmal nocturnal dyspnea with two-pillow orthopnea. He has taken aspirin daily since a myocardial infarction 3 years ago. He has a history of atrial fibrillation well controlled with digoxin and type 2 diabetes mellitus treated with diet. His blood pressure is 136188 mm Hg, pulse is 98/min and irregular, and respirations are 20/min. Jugular-venous pressure is increased. Breath sounds are decreased over the right lung base.. there is dullness to percussion. Cardiac examination shows an S. gallop. There is 2+ edema of the lower extremities. Pulse oximetry shows an oxygen saturation of 90%. Which of the following is the most appropriate next step in diagnosis?
A) X-ray film of the chest
B) Ambulatory ECG monitoring
C) Thallium stress test
D) Echocardiography
E) Ventilation-perfusion lung scans
CHF D
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| tamerbashir
Forum Elite
Topics: 21
Posts: 285
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NEXT STEP X ray
daignostic ECHO
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