Case Background

A thirty-five year old woman comes to your office with progressive dyspnea over the last year. Over the last three months, she has had abdominal and ankle swelling. Her heart rate is 60 bpm and her blood pressure is 90/70 mmHg. You listen at the lower left sternal edge with firm pressure on the diaphragm.



Choose the best description of the acoustic events at the lower left sternal edge: