A patient with significant shortness of breath that resolves with rest may be experiencing:

The scenario presented suggests that the patient experiences significant shortness of breath that improves with rest. This clinical pattern is often indicative of congestive heart failure (CHF) rather than peripheral arterial disease or the other listed choices.

In congestive heart failure, patients commonly experience dyspnea (shortness of breath) that can worsen with exertion due to increased fluid in the lungs and the heart's decreased ability to pump effectively, leading to increased strain on the body during physical activity. When the patient rests, the heart requires less demand, and the fluid does not accumulate as quickly, allowing for breathing to improve.

While acute coronary syndrome can lead to shortness of breath due to inadequate blood flow to the heart muscle, it typically presents with more severe symptoms and is often associated with chest pain and other serious complications. Similarly, cirrhosis of the liver might cause fluid retention and breathing difficulties, but this wouldn't typically resolve quickly with rest in the same way as in CHF.

Peripheral arterial disease does cause symptoms related to blood flow to the extremities, particularly during activity, but it does not directly relate to the respiratory symptoms described.

In summary, the patient’s relief of shortness of breath with rest aligns with the pathophysiology of