A 65-Year-Old Woman with Chronic Obstructive Pulmonary Disease Comes to the Office

A 65-year-old woman with chronic obstructive pulmonary disease comes to the office for a follow-up appointment.  The patient reports increasing shortness of breath that is not relieved by her inhalers.  Her other medical conditions include osteoarthritis.  She is a former smoker with a 45-pack-year history.  Blood pressure is 120/70 mm Hg, pulse is 75/min, and respirations are 22/min.  Oxygen saturation on room air is 91% at rest.  On physical examination, jugular venous pressure is elevated.  There is increased intensity of the pulmonic component of S2.  Breath sounds are decreased bilaterally with scattered wheezes but no crackles.  There is 2+ lower extremity edema.  Which of the following hemodynamic parameters is most likely to be increased in this patient?

A) Left ventricular preload
B) Left ventricular stroke volume
C) Pulmonary arterial compliance
D) Pulmonary capillary wedge pressure
E) Right ventricular afterload

Correct Answer:

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