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A 69-year-old female comes to the emergency department complaining of chest pain and difficulty breathing. She reports that she had a heart attack a few weeks ago that was treated with cardiac catheterization. At that time she had chest pain, but reports that this chest pain is different. A review of systems is significant for headaches, a productive cough with frothy sputum, and paresthesias in her fingertips. The patient’s temperature is 99°F (37.2°C), blood pressure is 130/78 mmHg, pulse is 78/min, and respirations are 20/min with an oxygen saturation of 96% O2 on room air. A chest radiograph is obtained, as shown in Figure A. Which of the following would you expect to find upon physical exam?
Decreased tactile fremitus
Increased tympanic percussion
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A 67-year-old male comes into the ED complaining of dyspnea and a heavy feeling in his chest. He reports that over the past month he has become more easily “winded" to the point that he now sleeps in his living room because he can’t make it up the stairs. A review of systems is notable for headaches and fatigue. On physical exam you note decreased breath sounds and a dullness to percussion on the right. A chest radiograph is obtained, which shows a right-sided pleural effusion. Thoracocentesis is performed and the fluid is analyzed, with results shown below:Volume: 30 cc of fluidPleural fluid protein: 5.8 g/dLSerum protein ratio: 7.0 g/dLLactate dehydrogenase (LDH): 258 U/LWhich of the following conditions may have led to the findings in this patient’s pleural cavity?
Congestive heart failure