Medicine

A 65 year old retired accountant with a 60 pack year smoking history presents for his annual physical examination. He was last seen 3 years ago, when he presented with an episode of acute bronchitis. He repos that he has been coughing over the past several months with productive green sputum. He denies any dyspnea or limitation in his daily activities. On physical examination, his blood pressure is 126/62 mm Hg, pulse is 80/min, and respirations are 24/min. He has diffuse bilateral expiratory rhonchi with a markedly prolonged expiratory phase. His cardiac examination reveals a second hea sound that increases in intensity with inspiration. The liver edge is 14 cm into the midclavicular line and mildly tender to palpation. There is bilateral lower extremity edema to the knees. A chest x-ray film reveals hyperinflation of both lung fields, and pulmonary function tests reveal a diminished forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio. Routine laboratories are sent. Which of the following would most likely be expected?