A 72-year-old man complains of lower extremity edema, sensation of heaviness in the right subcostal area, dyspnea in rest. For over 25 years he has been suffering from COPD. Objectively: orthopnea, jugular venous distention, diffuse cyanosis, acrocyanosis. Barrel chest is observed, on percussion there is vesiculotympanitic (bandbox) resonance, sharply weakened vesicular respiration on both sides, moist crepitant crackles in the lower segments of the lungs. Heart sounds are weakened, the II heart sound is accentuated over the pulmonary artery. The liver is +3 cm. What complicated the clinical course of COPD in this patient?

Answer options

1. Diffuse pneumosclerosis
2. Community-acquired pneumonia
3. Chronic pulmonary heart
4. Pulmonary embolism
5. Acute left ventricular failure

Explanation

A 72-year-old man complains of lower extremity edema, sensation of heaviness in the right subcostal area, dyspnea at rest. For over 25 years he has been suffering from COPD. Objectively: orthopnea, jugular venous distention, diffuse cyanosis, acrocyanosis. Barrel chest is observed, on percussion there is a vesicular tympanitic (bandbox) resonance, sharply weakened vesicular respiration on both sides, moist crepitant crackles in the lower segments of the lungs. Heart sounds are weakened, the II heart sound is accentuated over the pulmonary artery. The liver is +3 cm. What complicated the clinical course of COPD in this patient?Pulmonary heart disease, also known as cur pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungsChronic pulmonary heart disease happens when the right ventricle must work too hard to pump blood to the lungs that have been damaged. The lungs may have been damaged by a condition like COPD (chronic obstructive pulmonary disease), blood clots in the lung, or sleep apnea.Pulmonary hypertension symptoms include:Shortness of breath (dyspnea), initially while exercising and eventually while at rest.Fatigue.Dizziness or fainting spells (syncope)Chest pressure or pain.Swelling (edema) in your ankles, legs, and eventually in your abdomen (ascites)