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A 69-year-old retired man is brought to the emergency department
because he experienced sudden onset of left-sided chest
pain, which is exacerbated upon inspiration. He is taking no
medications and has been in good health. Physical examination
reveals dyspnea and hemoptysis. Temperature is 38°C
(101°F), pulse rate is 98 per minute, respirations are 35 per
minute, and blood pressure is 158/100 mm Hg. A pleural friction
rub is present on auscultation. The left leg is markedly
edematous, with a positive Homans’ sign. An ECG shows a
normal sinus rhythm. A chest X-ray reveals a left pleural effusion.
What is the most likely cause of this patient’s pulmonary
condition?
(A) Congestive heart failure
(B) Cor pulmonale
(C) Mitral stenosis
(D) Subacute endocarditis
(E) Thromboembolism
The answer is E (and I see it) but can someone explain why A&B are wrong?
because he experienced sudden onset of left-sided chest
pain, which is exacerbated upon inspiration. He is taking no
medications and has been in good health. Physical examination
reveals dyspnea and hemoptysis. Temperature is 38°C
(101°F), pulse rate is 98 per minute, respirations are 35 per
minute, and blood pressure is 158/100 mm Hg. A pleural friction
rub is present on auscultation. The left leg is markedly
edematous, with a positive Homans’ sign. An ECG shows a
normal sinus rhythm. A chest X-ray reveals a left pleural effusion.
What is the most likely cause of this patient’s pulmonary
condition?
(A) Congestive heart failure
(B) Cor pulmonale
(C) Mitral stenosis
(D) Subacute endocarditis
(E) Thromboembolism
The answer is E (and I see it) but can someone explain why A&B are wrong?
