man presented to his primary physician with dyspnea. His medical and
social histories revealed hypertension, coronary artery disease,
congestive heart failure, anemia, hypothyroidism and asbestos exposure.
He had quit smoking 19 years ago, having accumulated a 70 pack-year
General physical exam: slightly obese in no respiratory distress. Vital
signs: Temperature 35.9°C, respirations 26/min, pulse 96 beats/min,
BP 160/65 mm Hg, height 180.3 cm, and weight 106.2 kg. Neck: mild
jugular venous distension. Lungs: bibasilar crackles present, no
wheezing noted. Cardiac: S3 present, no rub or murmur
detected. Extremities: chronic venous stasis changes present, no
clubbing or cyanosis found.