A 60-year-old obese man comes to the emergency department with tightness in his chest and lower extremity edema. He has a history of heart failure that has worsened over the last several years. He takes finasteride, lisinopril, and albuterol. He does not use oxygen at home. His blood pressure is 142/94 mm Hg, heart rate is 112/min, and respiratory rate is 18/min. Physical examination shows an overweight man with difficulty speaking and with 2+ pitting edema on his lower extremities up to his thighs. The attending physician asks you to chart out the patient's theoretical cardiac function curve from where it was 5 years ago when he was healthy to where it is right now. What changes have likely occurred in the last several years without compensation?
