Question

A 75-year-old African-American man presents with a 5-month history of gradually progressive dyspnea that is especially pronounced when climbing stairs. He also has been noticing that his ankles and lower legs have "gotten larger" over roughly the same time period, which no longer allows him to fit into his sneakers. He denies fever, chills, chest pain, palpitations, cough, pleurisy, calf pain, abdominal complaints, sick contacts, or travel. His psychosocial history is noteworthy for chronic alcohol use. His physical exam reveals bibasilar rales, JVD of 5cm, an S3 gallop, a holosystolic murmur at the apex that radiates to the left axilla, and 2+ pitting edema to the level of the mid-calves bilaterally. A bedside echocardiogram was remarkable for biventricular enlargement.

What additional physical exam finding would be expected in this patient?

1 Tachycardia
2 Fever
3 Asymmetric upper extremity blood pressures
4 Warm, moist skin
5 Acanthosis nigricans

Answer 1

The additional physical exam finding expected in this patient is tachycardia.

Step-by-step explanation:

The additional physical exam finding that would be expected in this patient is tachycardia. Tachycardia refers to an abnormally fast heart rate. In this case, the patient's heart rate is likely elevated as a compensatory mechanism to maintain cardiac output and perfusion due to his heart failure symptoms, such as dyspnea, ankle and leg edema, and physical findings of bibasilar rales, JVD, S3 gallop, and biventricular enlargement on echocardiogram.