CLINICAL INFORMATION

History of Present Illness

• 64-year-old white male with 2 years of worsening exercise capacity
• No associated cough or constitutional symptoms
• No symptoms of connective tissue disease
• No occupational exposures or exposures to any organic or inorganic dusts
• Habits: smoked cigars for 20 years, stopped 8 years ago

Past Medical History

• Hypercholesterolemia
• Degenerative osteoarthritis
• Renal stones
• Dupuytren's contracture

Medications

• Atorvastatin - Lipitor®
• Fexofenadine - Allegra®
• Aspirin
• Vitamin C and E
• Glucosamine chondroitin

Patient History

Family History

• Negative for pulmonary disease

Social History

• Smoked as above
• Drinks socially
• Employed as sales consultant

Physical Exam

• The patient is in no distress on room air. Oxygen saturation 97%. Early clubbing noted.
• HEENT neg
• Pulmonary: scattered basilar crackles (not typical "Velcro®")
• Cardiac: normal S₁ and S₂
• Remainder of exam is negative