A 63-year-old white woman presents after admission to the general medical/surgical hospital ER with a primary complaint of shortness of breath on exertion. She reports that she was seen for similar symptoms at her primary care physician's office three months ago. During that visit, she was diagnosed with acute bronchitis and treated with bronchodilators, antibiotics, and a short course of prednisone. This care management did not improve her symptoms, and she has progressively worsened over the past three months. She denies contacts with any person with infections. A review of systems reveals that the client is afebrile, denies night sweats, insomnia, sleep apnea, constipation, diarrhea, abdominal tenderness, CMS changes, muscular skeletal changes. Client admits cough, shortness of breath, and shortness of breath on exertion. What is the most likely cause of her symptoms?
1) Acute bronchitis
2) Pneumonia
3) Chronic obstructive pulmonary disease (COPD)
4) Pulmonary embolism