Problem
A patient presents with complaint of dyspnea and lower extremity edema. His Chest X ray is pictured below. Labs reveal a BNP of 1000 otherwise CBC, Chemistry, Magnesium, Calcium, Phosphorous are all normal. Medications include Procardia, and Metoprolol both prescribed for hypertension. No other medical or surgical history. PE: reveals bibasilar crackles and expiratory wheeze. What differential diagnoses should be considered? Are there any ethical issues for discussion?