Skill Checkup: A 62-Year-Old Black Male With History of Hypertension Experiences Mild Cognitive Impairment and Breathlessness

Jeffrey J. Hsu, MD


March 13, 2023

The patient's presentation of mild cognitive impairment, breathlessness with minor exertion, fatigue, lower extremity edema, and weak appearance, along with chest radiographic findings of an enlarged cardiac silhouette and lung base edema, all point to acute HF as the most likely diagnosis.

Pulmonary embolism can also present with similar symptoms, but the lack of risk factors, such as recent surgery or immobilization, makes it a less likely diagnosis in this scenario. COPD, while a possibility given the patient's history of hypertension and presence of rales and wheezing on examination, is not as consistent with the patient's presentation and the chest radiograph findings. Pneumonia is not a likely diagnosis given the lack of fever and the presenting symptoms.


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