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USLME Step 2 Review
Question #14 A 58 year old male with a history of diabetes, hypertension, and a renal transplant presents to the emergency department after being found unresponsive at home. His temperature is 37.3 C, blood pressure is 70/30, heart rate 120, respirations 24, and oxygen saturation 70% on room air. Physical examination reveals bilateral pulmonary rales, a S4 heart sound is present, and no murmurs could be auscultated. He is intubated for airway protection. ECG reveals sinus tachycardia with a left bundle branch block. A Swan-Ganz catheter is inserted and the values are below: Right atrial presssure - 8 mmHg Right ventricular pressure - 38/8 mmHg Pulmonary artery pressure - 42/22 mmHg Pulmonary capillary wedge pressure - 26 mmHg Cardiac output - 4.0 L/min Cardiac index - 2.0 L/min Which of the following is the most likely diagnosis? 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9
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