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ACCP-SEEK Board Review Question of the Month |

54-Year-Old Man With Dyspnea, Cough, and Hypoxemia*

Marvin I. Schwarz, MD, FCCP
Author and Funding Information

*From the ACCP-SEEK program, reprinted with permission. Items are selected by Department Editors Richard S. Irwin, MD, FCCP, and John G. Weg, MD, FCCP. For additional information about the ACCP-SEEK program, phone 1-847-498-1400.

Correspondence to: Marvin I. Schwarz, MD, FCCP, Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, 4200 E. 9th Ave, Box C272, Denver, CO 80262; e-mail: Marvin Schwarz@UCHSC.edu



Chest. 2000;118(4):1198-1201. doi:10.1378/chest.118.4.1198
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Extract

A 54-year-old man has developed gradual onset of dyspnea and nonproductive cough over the past 6 months. He was an avid rock climber and long-distance runner; now, he is unable to perform either of these activities. He was first referred to a cardiologist, who found the results of the following tests to be normal: ECG, exercise stress test, and cardiac catheterization. His medical history is nonrevealing. He has not smoked for the past 10 years.

Physical examination reveals a healthy, muscular man who is comfortable at rest. His vital signs are normal. Lung auscultation reveals bibasilar end-expiratory crackles. His extremities are not edematous or clubbed. The remainder of the physical examination is normal.

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