CLINICAL INFORMATION

History of Present Illness

• 52-year-old Caucasian male with history of insidious onset of shortness of breath
• SOB especially noticeable over the last year
• Patient is somewhat sedentary and on reflection believes that he has had SOB on and off over the last 9 years
• Patient notes a chronic cough with occasional sputum production
• Patient recently started an exercise program and is able to ambulate for about 10 minutes on a treadmill, but only on a level plane

Past Medical History

• Hypertension, on lisinopril x 5 years

Patient History

• Habits: former 1 pack per day smoker x 15 years. Stopped 17 years ago
• Occupation: Jeweler
• Social: lives with his wife and son in a townhouse. The family has one dog and two parakeets
• Review of symptoms:
• Some recent weight loss, but he is uncertain as to the amount
• Joint pains affecting his hands on and off for the last year

Physical Exam

• Significant clubbing and some bibasilar inspiratory crackles