Skill Checkup: An 81-Year-Old Woman With Dyspnea, Nearly Incessant Cough, and Body Aches

Enrico Brunetti, MD

November 07, 2022

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

An 81-year-old woman in Europe presents with dyspnea, nearly incessant cough, and body aches. Symptom onset was 9 days ago; at first, the patient attributed her dyspnea to heart failure and age. She notes that she intended to schedule a telemedicine appointment closer to symptom onset but was not familiar with the technology. The patient was vaccinated for coronavirus disease 19 (COVID-19) last year but has not received a booster shot. The patient manages heart failure with captopril, sotalol, and bumetanide. She also takes risedronate for osteoporosis. Her daughter has accompanied her, and the patient appears somnolent. Body temperature is 37.2°C (99°F), heart rate is 110 per minute, respiratory rate is 34 per minute, and oxygen saturation is 86%. Chest CT shows diffuse ground glass-like opacity in both lungs. Polymerase chain reaction tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detected by nasopharyngeal swabs come back positive. Accessory muscle use is noted, but physical examination is otherwise normal.

1 2 3 4 5 6

Next Section

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Enrico Brunetti. Skill Checkup: An 81-Year-Old Woman With Dyspnea, Nearly Incessant Cough, and Body Aches - Medscape - Nov 07, 2022.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.