CASE STUDY:
69-Year-Old Female With Chronic Cough and Dyspnea

CLINICAL INFORMATION

HISTORY OF PRESENT ILLNESS

A 69-year-old African American female from Arizona, with a past medical history significant for peptic ulcer disease presented in 3/2001 with complaints of increasing shortness of breath on exertion and a cough. The patient noted that the dyspnea and cough had been present for approximately 12 months, and had progressed over the prior 6 months while visiting her family in California. She further explained that her cough was the major debilitating symptom, describing it as dry and only improved with oxycodone. Of note, her shortness of breath had progressed to the point that she could only walk 2 blocks without sitting for a breather. In 9/2000 she had a serologic work-up for connective tissue disease that was negative.

PAST MEDICAL HISTORY

As noted above, the patient had a history of peptic ulcer disease for which she was treated at age 20. Furthermore, she recently tested positive for H. pylori for which she took a course of metronidazole and tetracycline. She denied any history of surgery.

SOCIAL HISTORY

The patient denied the use of alcohol or any illicit drugs but did admit to having smoked cigarettes (1 pack/day for the past 15 years). She quit smoking 3 months prior to her visit because of her cough and dyspnea. No clinically significant environmental or occupational exposures were present.

FAMILY HISTORY

The patient denied any cardiac, pulmonary, or connective tissue disease among her family members. Her father died from advanced prostate cancer and her mother is still living with diabetes mellitus and hypertension. She has no siblings.