Steve McManus a 60-year-old man presents to the GCUH emergency department with worsening…

Steve McManus a 60-year-old man presents to the GCUH emergency department with worsening shortness of breath and chest pain. After physical examination he is noted to have elevated neck veins, a parasternal heave, a prominent S2, and a significantly enlarged liver. Steve was diagnosed with COPD 10 years ago and has a history of uncontrolled hypertension, sleep apnoea, and has been a heavy smoker and drinker for more than 40 years.

After subsequent diagnostic testing, Steve is diagnosed with right-sided heart failure due to his COPD.

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