Review Question - QID 216353

A 62-year-old man presents to the emergency department for evaluation of shortness of breath. He reports progressively worsening dyspnea over the last 24 hours. He states that he enjoyed fried food at a recent backyard barbecue 2 days ago, and also spent 1 hour extinguishing a charcoal grill fire in an enclosed gazebo. He also tripped and injured his left calf. He has a 30 pack-year smoking history as well as a previous myocardial infarction (MI) 5 years ago. His temperature is 99.0°F (37.2°C), blood pressure is 115/70 mmHg, pulse is 105/min, and respirations are 25/min with an oxygen saturation of 91% on room air. On exam, he demonstrates bilateral lower extremity edema with left anterior shin tenderness, bibasilar lung crackles, an S3 heart sound, and jugular venous distension (JVD). Which of the following is also likely to be found in this patient?