A 60-year-old male with coronary artery disease presents with worsening dyspnea and lower extremity edema. What is a likely physical examination finding?

In this scenario, the 60-year-old male with coronary artery disease exhibiting worsening dyspnea and lower extremity edema is suggestive of heart failure, potentially due to left ventricular dysfunction. The presence of a third heart sound (S3) is a common physical examination finding in patients with heart failure and is often associated with increased filling pressures in the atria and ventricles.

The third heart sound occurs during the rapid filling phase of the ventricle and can be described as a low-pitched sound that follows the second heart sound (S2). It indicates that the ventricles are not accommodating blood as effectively as they should, which is a hallmark of heart failure. This sound can be a sign of volume overload, as seen in congestive heart failure, which correlates well with the symptoms of dyspnea and peripheral edema experienced by this patient.

In contrast, the other findings may have different significances. A pericardial friction rub is typically associated with pericarditis, an inflammation of the pericardial sac, and is not directly related to heart failure. An accentuated first heart sound is usually indicative of conditions such as hypertension or aortic stenosis rather than heart failure. A mid-systolic click is