A 75-Year-Old Man With Dyspnea and Chest Pain

Giovanni Volpicelli, MD

Disclosures

November 30, 2016

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

A 75-year-old man presents to the emergency department (ED) with a dry cough and dyspnea on exertion. The cough began 2 weeks ago and has been progressively worsening. The patient began experiencing dyspnea approximately 1 week ago. He also notes left-sided chest pain.

The patient has a history of coronary artery disease with recent coronary bypass surgery, recurrent episodes of bilateral spontaneous pneumothoraces, and chronic obstructive pulmonary disease (COPD). He has smoked an average of 15 cigarettes daily for 40 years. His symptoms have drastically worsened by the time of presentation to the ED.

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