Department of Pulmonary Critical Care, Cleveland Clinic Weston, Weston, FL.
Department of Pulmonary Critical Care, Cleveland Clinic Weston, Weston, FL.
Chest. 2024 Sep;166(3):e83-e87. doi: 10.1016/j.chest.2024.05.001.
A 76-year-old male Vietnam veteran with a medical history of OSA on CPAP, mild COPD, Parsonage-Turner syndrome (a rare neurologic syndrome manifesting with shoulder and arm pain), hypertension, gastroesophageal reflux, hiatal hernia, and prior endocarditis presented with 1 year duration progressive exertional dyspnea with minimal activity by referral from an outside pulmonologist. The patient reported possible exposure to Agent Orange during his service but was otherwise without significant occupational or environmental exposures. His exercise tolerance was well-maintained up until the last 12 months. Aside from marginal cigarette use, he denied any recreational drug use or any anorectic use. The patient provided records from a recent right heart catheterization (RHC) months earlier for review.
一位 76 岁的男性越南老兵，有 OSA 病史，使用 CPAP 治疗，轻度 COPD，颈神经根综合征（一种罕见的神经系统综合征，表现为肩部和手臂疼痛），高血压，胃食管反流，食管裂孔疝，以及既往心内膜炎。患者因呼吸困难进行性加重 1 年就诊，轻微活动后即感气促，由一名外部肺科医生转诊而来。患者报告称在服役期间可能接触过 Agent Orange，但无其他显著职业或环境暴露。他的运动耐量直到过去 12 个月才保持良好。除了偶尔吸烟外，他否认使用任何娱乐性药物或食欲抑制剂。患者提供了最近一次右心导管检查（RHC）的记录供医生审查。
