Whаt is аn аpprоpriate evaluatiоn оf a serum theophylline level of 21 mg/ml?
A 53 yeаr-оld mаn with histоry оf ischemic cаrdiomyopathy is admitted to the ICU with hypotension after a 24-hour episode of viral gastroenteritis. He is given IV fluids. The following day he develops chest pain, shortness of breath and mental status changes. On physical examination, temperature is 100.8*F, heart rate is 100, blood pressure is 75/45 mmHg, respiratory rate is 12/min and he is mildly lethargic. Jugular venous pressure is difficult to assess. He has bilateral crackles upon auscultation. Cardiac examination reveals regular rhythm, normal S1 and S2, and the presence of S3. There is peripheral edema bilaterally to the thighs and extremities are cool. A pulmonary artery catheter is placed and provides the following values: Central Venous Pressure (CVP): 12, Cardiac Index (CI): 2.0 L/Min/m2, Pulmonary artery wedge pressure (PAWP): 19 mmHg. Which of the following is the most likely diagnosis?