Image of the Week: Subacute shortness of breath and fatigue in a 70-year-old man

A 70-year-old man is brought to the emergency department with subacute shortness of breath and fatigue. After searching her father's home, his daughter reports that she found his medication—a nearly-empty bottle of metoprolol, 100 mg bid. She believes her father has coronary artery disease. On examination, the patient is confused. His blood pressure is 69/49 mmHg and he ...