July 26th, 2020
Five days after admission to the hospital for an acute myocardial infarction, a 60-year-old man complains of shortness of breath. His temperature is 37°C (98.6°F), pulse is 120/min and regular, respirations are 40/min, and blood pressure is 70/40 mm Hg with no pulsus paradoxus. Jugular venous pulsations are present 7 cm above the sternal angle. Crackles are heard at both lung bases. Cardiac examination shows a holosystolic murmur radiating to the axilla. Which of the following is the most likely diagnosis?