A 70-year-old man is found unresponsive at home. The emergency medical technicians note his blood pressure to be 70 mmHg by palpation. His pulse is 120/min. He is brought to the emergency department, where his temperature is 39.5 C (103 F), and respirations are 30/min. He has rales half way up his chest. Heart sounds are inaudible. His urine out put s 10mL/hr. A chest x-ray film reveals fine constophrenic septal lines, and an electrocardiogram shows sinus tachycardia. He is given antibiotics and is taken to the intensive care unit, where a right-sided catheterization shows an elevated wedge pressure and diminished cardiac output. His right atrial pressure is not elevated. Which of the following is the most likely cause of this man's hypotension?
A. Gastrointestinal bleeding
B. Gram-negative sepsis
C. Left ventricular dysfunction
D. Pericardial tamponade
E. Pulmonary embolus
A. Gastrointestinal bleeding
B. Gram-negative sepsis
C. Left ventricular dysfunction
D. Pericardial tamponade
E. Pulmonary embolus