Right heart failure (cor pulmonale) Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 72-year-old woman presents to the cardiologist for evaluation of worsening dyspnea with exertion for three months. She reports a significant increase in lower extremity swelling and abdominal fullness over this time. The patient states that she can only walk to the bathroom in her home before becoming severely short of breath. She has difficulty performing her activities of daily living due to the symptoms. Two months ago, an echocardiogram revealed severe tricuspid valve regurgitation without evidence of elevated estimated pulmonary artery systolic pressure. She has been compliant with her prescribed furosemide as well as fluid and salt-restriction. She uses prescribed supplemental oxygen as needed. Past medical history is notable for hypertension, diabetes, hyperlipidemia, and coronary artery disease for which she takes carvedilol, metformin, atorvastatin, and a baby aspirin daily. Temperature is 37°C (98.6°F), pulse is 86/min, respirations are 16/min, blood pressure is 146/74 mmHg, and oxygen saturation is 93% on room air. The patient appears fatigued but is not in respiratory distress. Cardiopulmonary examination reveals a holosystolic murmur, right-sided S3, and jugular venous distention. 2+ pitting edema of the lower extremities bilaterally and abdominal distension are also present. The lungs are clear to auscultation bilaterally. Which of the following is the best next step in management?  

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