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Pulmonary, Critical Care, and Sleep Pearls |

A 61-Year-Old Man With Shortness of Breath, Ascites, and Lower Extremity Edema

Ali Ataya, MD; Jessica M. Cope, PharmD; Diego Moguillansky, MD; Tiago N. Machuca, MD, PhD; Hassan Alnuaimat, MD
Author and Funding Information

CORRESPONDENCE TO: Ali Ataya, MD, 1600 SW Archer Rd, M452, PO Box 100225, Gainesville, FL, 32610


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(6):e195-e199. doi:10.1016/j.chest.2015.12.037
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A 61-year-old man presented with an 18-month history of progressive shortness of breath on exertion, fatigue, worsening bilateral lower extremity edema, abdominal swelling, and increased assistance with activities of daily living. Pertinent past medical history included right-sided pneumonia secondary to Streptococcus pneumoniae that was complicated by empyema, requiring right-sided video-assisted thoracoscopic surgery with decortication 2 years earlier. He had a negative cardiac history, no recent travel in the last 3 years, and no known exposure to tuberculosis. His medications included aspirin and daily furosemide. His symptoms appeared to be refractory to diuretic therapy. Previous workup 6 months earlier included an echocardiography (ECHO) showing enlarged left and right atria with a normal ejection fraction, and a catheterization of the left side of the heart with reported normal left ventricular function and unobstructed coronary arteries.

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