A 54-Year-Old Man Comes to the Emergency Department Due to Worsening

A 54-year-old man comes to the emergency department due to worsening shortness of breath for the last 3 days.  His symptoms initially occurred with exertion but are now present at rest.  The patient could not sleep last night because of a suffocating cough each time he tried to lie down.  He considers himself generally healthy and states, "I've never had to see a doctor for any problems."  Family history is remarkable for asthma and hypertension.  Blood pressure is 162/86 mm Hg, pulse is 92/min, and respirations are 26/min.  An x-ray of the chest is shown in the exhibit. 
Which of the following is the most likely diagnosis?

A) Acute decompensated heart failure
B) Acute respiratory distress syndrome
C) Idiopathic pulmonary fibrosis
D) Obstructive pulmonary disease
E) Pulmonary arterial hypertension
F) Tension pneumothorax

Correct Answer:

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