A 56-year-old man comes to the office due to worsening cough for the past several months. He initially had a morning cough productive of minimal sputum, but now the cough occurs throughout the day with large amounts of yellowish sputum. The patient also has breathlessness on moderate exertion. He has had 3 hospitalizations over the past year for respiratory infections. The patient has smoked a pack of cigarettes daily for the past 30 years and has failed multiple attempts to quit. Oxygen saturation is 90% at rest and decreases to 84% with moderate exertion. Which of the following additional findings is most likely to be seen in this patient?
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