Right heart failure (cor pulmonale) Quiz: Ace Your Exams
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A 76-year-old man presents to the cardiologist for evaluation of worsening dyspnea on exertion over the past several months. The patient was initially seen by his primary care physician for shortness of breath and was referred to a pulmonologist. Pulmonary function tests revealed findings consistent with chronic obstructive pulmonary disease. Despite bronchodilator therapy and smoking cessation, the patient has not had relief of symptoms and continues to have dyspnea on exertion, early satiety, and abdominal fullness. Additional past medical history includes hypertension for which he takes amlodipine. Temperature is 37°C (98.6°F), pulse is 86/min, respirations are 16/min, blood pressure is 124/64 mmHg, and oxygen saturation is 94% on room air. The patient is in no acute distress and is resting comfortably on the examination table. Cardiopulmonary examination reveals a loud P2 but no murmurs, rubs, or gallops. Jugular venous distention is present. The lungs are clear to auscultation bilaterally. The abdomen is soft but distended, and 2+ pitting edema is present in the lower extremities bilaterally. An echocardiogram is ordered. Which of the following findings is most likely to be seen on echocardiogram?
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