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Medicine, 13.03.2020 19:17 kaliyab191

A 78-year-old woman is seen in the emergency department for difficulty breathing and cough over the past 4 hours. She has a history of congestive heart failure for which she takes hydrochlorothiazide, metoprolol, and enalapril. Her oxygen saturation is 92% on room air. On examination there is a high-pitched systolic crescendodecrescendo murmur best heard at the right upper sternal border with radiation to the carotids, and rales are present in both lung fields on inspiration. There is 2+ symmetrical pitting edema bilaterally in the lower extremities. X-ray of thechest shows an enlarged heart and prominent pulmonary vasculature. Which of the following is themost likely cause of the patient’s pulmonary edema?

(A) Decreased capillary fluid oncotic pressure

(B) Decreased interstitial fluid hydrostatic pressure

(C) Increased capillary fluid hydrostatic pressure

(D) Increased capillary permeability

(E) Increased interstitial fluid oncotic pressure

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