An 89-year-old female with a history of smoking exhibits dyspnea and pink frothy sputum. What condition should you suspect?

The presence of dyspnea and pink frothy sputum in an 89-year-old female with a history of smoking strongly suggests congestive heart failure (CHF). In CHF, the heart struggles to pump effectively, leading to fluid buildup in the lungs, which manifests as pulmonary edema. This condition often results in the production of pink, frothy sputum due to the mixing of air with the fluid.

Patients with CHF frequently have symptoms of dyspnea due to the accumulation of fluid in the lungs. The pink color of the sputum indicates the presence of blood and is characteristic of pulmonary edema seen in CHF. Given that the patient is also elderly with a significant smoking history, she may have underlying cardiovascular issues that predispose her to heart failure.

While chronic obstructive pulmonary disease (COPD) and pneumonia could also produce similar respiratory symptoms, the specific combination of pink frothy sputum strongly aligns with the clinical picture of congestive heart failure, making it the most likely condition to suspect in this scenario.