A 75-year-old woman comes to the physician because of an 8-week history of non-productive cough and shortness of breath. She has been smoking one pack of cigarettes daily for 55 years. Physical examination shows a point of maximal impulse in the subxiphoid space. A 2/6 holosystolic murmur is auscultated along the left sternal border that is accentuated with inspiration. There is a loud pulmonic component of S2. The patient’s chest radiograph is shown below.
Which of the following is the most likely cause of the patient’s examination findings?
Decreased left ventricular compliance
Decreased right ventricular compliance
Diminution of alveolar capillary beds
Primary pulmonary hypertension
Pulmonic valvular incompetence secondary to lung disease
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Cut-to-the-chase Answer (0:59):
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HY USMLE Answer (12:10):
