Amy is a 57-year-old African-American woman seen at an urgent care clinic for a headache not relieved by acetaminophen or ibuprofen. Physical examination reveals an overweight woman who is short of breath from the walk to the examination room. Her fingers are puffy with tight rings that she is unable to remove. M.H. reports she has a history of cigarette smoking, primary hypertension, high cholesterol, and type 2 diabetes. Select a potential diagnosis for M.H. and describe the pathophysiology of that diagnosis. How does the pathophysiology explain M.H.’s physical exam findings and how does her medical history contribute to the pathophysiology?

Amy is a 57-year-old African-American woman seen at an urgent care clinic for a headache not relieved by acetaminophen or ibuprofen. Physical examination reveals an overweight woman who is short of breath from the walk to the examination room. Her fingers are puffy with tight rings that she is unable to remove. M.H. reports she has a history of cigarette smoking, primary hypertension, high cholesterol, and type 2 diabetes. Select a potential diagnosis for M.H. and describe the pathophysiology of that diagnosis. How does the pathophysiology explain M.H.’s physical exam findings and how does her medical history contribute to the pathophysiology?