Orthopnea (uses Three Pillows) in Medicine / Internal Medicine — 68yo Man | Cardiology | SMLE Q#12234
SMLE Question #12234
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 68-year-old man has 3 months of progressive shortness of breath with orthopnea (uses three pillows) and paroxysmal nocturnal dyspnea. He reports worsening bilateral leg swelling and a 4-kg weight gain over 6 weeks. Examination shows elevated jugular venous pressure, bilateral basal crackles, pitting edema to the knees, and an S3 heart sound. What is the most likely diagnosis?
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