10th September 2020

A 78-year-old lady presents with a 4-day history of worsening dyspnoea, productive cough and swollen ankles

A 78-year-old lady presents with a 4-day history of worsening dyspnoea, productive cough and swollen ankles. Her sputum is pink and frothy. She has had to sleep propped up with two extra pillows at night to relieve her breathlessness. She has a past medical history of ischaemic heart disease and hypertension. On examination, she has a raised JVP, central cyanosis, an extra heart sound (S3) and bi-basal crackles. 

Her basic observations are: T 37.0, Oxygen saturations 92%, RR 30, HR 125, BP 150/95

Chest X-ray reveals cardiomegaly, pulmonary and upper lobe venous congestion.

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.