Extract
A 28-year-old Asian man noted the insidious onset of exertional dyspnoea over a 4-month period. This was associated with an intermittent dry cough and expiratory wheezing noted only with exercise. He noted no specific aggravating or alleviating factors and denied associated haemoptysis, chest pains, acid reflux, or systemic findings such as fever, sweats or weight loss. He had no prior history of childhood asthma. He was a full-time student without a recent change in environmental or occupational exposures. He denied choking while eating or drinking, changes in his voice or exposure to ill contacts. Evaluation by his primary care provider included a normal physical examination and a normal chest radiograph (figure 1). Spirometry was interpreted as showing a moderately severe obstructive defect (figure 2; initial presentation). There was no reversibility with bronchodilator (not shown).
Abstract
Spirometry provides clues to solving this puzzle of dyspnoea and wheeze in a young nonsmoker—the loops never lie! http://ow.ly/YC9zI
A 10 s recording of expiratory sounds from this case can be found at: http://ow.ly/UVVu300moD1
Footnotes
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Conflict of interest None declared.
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