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Pulmonary and Critical Care Pearls |

A 44-Year-Old Man With Suspected Exacerbation of COPD and Atrial Fibrillation*

Srinivasan Ramanuja, MD; John Mastronarde, MD, FCCP; Ian Dowdeswell, MD; Masoor Kamalesh, MD
Author and Funding Information

*From the Krannert Institute of Cardiology, Clarian Cardiovascular Center, Department of Medicine, Indiana University, Richard L. Roudebush VA Medical Center, Indianapolis, IN.

Correspondence to: Masoor Kamalesh, MD, Krannert Institute of Cardiology, Indiana University, Richard L. Roudebush Veterans Affairs Medical Center, Sixth Floor Cardiology, 1481 W. Tenth St, Indianapolis, IN 46202; e-mail: mkamales@iupui.edu



Chest. 2004;125(6):2340-2344. doi:10.1378/chest.125.6.2340
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A 44-year-old man with a long smoking history, COPD, and hypertension presented to the emergency department with 5 days of fever, productive cough, and shortness of breath. He had a 2-year history of dyspnea after walking one city block. Spirometry performed several months earlier showed a FVC ratio (FEV1/FVC) of 62% of predicted. He worked in a factory with extensive exposure to sawdust. His medications included diltiazem, albuterol, and salmeterol inhalers. He denied any allergies, and his family history was noncontributory.

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