A 50-year-old man is admitted for congestive heart failure. He has no history of chest pain or ethanol abuse. On physical examination he has a blood pressure of 190/120 mm Hg, mild hepatosplenomegaly, and no cardiac murmur. The heart failure is most likely due to:
A. myocardiopathy
B. myocardial infarct
C. aortic stenosis D. hypertension
E. pulmonary emboli
The correct answer is (D) hypertension.
The patient’s symptoms and physical examination suggest that the heart failure is due to uncontrolled hypertension, which has led to:
– Left ventricular hypertrophy and subsequent heart failure
– Mild hepatosplenomegaly due to increased venous pressure
– Absence of cardiac murmur, which makes valvular heart disease (e.g., aortic stenosis) less likely
The other options are less likely: