Review Question - QID 214489

A 74-year-old man presents to the emergency department with shortness of breath. He states that his shortness of breath has been worsening over the past week, and he has had a cough and a fever during this time frame as well. He is normally on 2L of O2 for his chronic obstructive pulmonary disease (COPD) but has increased it to 5L on his own. The patient is an active smoker and has diabetes. His temperature is 101°F (38.3°C), blood pressure is 174/100 mmHg, pulse is 115/min, respirations are 27/min, and oxygen saturation is 82% on 5L of O2. Physical exam reveals diffuse wheezes bilaterally. Jugular venous distension and bilateral lower extremity pitting edema are noted as well as distant heart sounds. Hepatomegaly is palpated on the abdominal exam. An ECG is performed as seen in Figure A. A chest radiograph demonstrates diffuse interstitial infiltrates. Which of the following is most likely to be found in this patient?