added tag b/c directly answers Q on NBME 12:
A 60-year-old man comes to the emergency department 6 hours after the onset of shortness of breath associated with a nonproductive cough. One year ago, he was diagnosed with mild hypertension. His pulse is 100/min, respirations are 26/min, and blood pressure is 140/105 mm Hg. Ophthalmoscopic examination shows arteriolar narrowing but no papilledema. There is no peripheral edema. An S , S , and crackles at the bases of both lungs are heard, and jugular veins are distended. Which of the following is the most likely diagnosis?
Ans: Congestive heart failure
Educational Objective: Congestive heart failure is a commonly encountered clinical syndrome associated with chronic hypertension and coronary artery disease. Physical examination findings can include elevated jugular venous pressure, peripheral edema, ascites, hepatojugular reflux, pulmonary crackles, and an S3 or S4 gallop.