You are assessing an unresponsive 66-year-old man with a his…

You are assessing an unresponsive 66-year-old man with a history of two prior strokes. According to the patient’s wife, he complained of a severe headache and then passed out. His respiratory effort is poor, blood pressure is elevated markedly, and pulse is slow and bounding. The glucometer reads “error.” You should:

Your 60 year old patient is complaining of difficulty breath…

Your 60 year old patient is complaining of difficulty breathing. He is speaking in 2-3 word sentences, leaning forward and laboring to breathe. He has a history of an acute MI two years ago. Physical exam reveals a blood pressure of 90/60, pulse of 110, and respiratory rate of 36. His neck veins are distended and edema of the lower extremities is present to the level of the mid-calf. Lung sounds reveal diffuse crackles. You suspect: