Problem
A 51-year-old male was admitted to the hospital because of shortness of breath when walking fast. He complained of a choking feeling in his throat just before he came to the hospital. Nineteen days before coming to the hospital he told his wife that he felt chest pain on his right chest but he felt it was only "gas". He has a history of hypertension and was admitted a year ago to a cardiac ICU for a possible left heart failure. In the last two months he noticed weight gain despite no change in his diet and the last two weeks he noticed that his ankles were a bit swollen. You noticed that during the last 10 minutes in the hospital his heart rate was 172 beats per minute and his blood pressure was 168/97 mmHg.
a) How would you conduct taking his cardiac history?
b) What are you looking for during his physical examination?
c) What clues might his electrocardiogram give you and what might it look like?
d) If you auscultated his chest and took a chest x-ray what would you find?
e) What types of cardiac diagnostic laboratory test would you order and why?