Question

Mr. S. is a retired 69-year-old county attorney who was on a buying trip with his wife looking for old, classic cars in the high, mountainous country of Colorado when he became extremely short of breath, much more than usual. His alarmed wife took him to a multispecialty medical clinic for evaluation.

Upon admission, Mr. S. was restless and dyspneic. His past history revealed a habit of smoking two packs of cigarettes a day for 45 years (90 pack years). During the past few years, Mr. S. noticed a cough each morning on arising. Recently, while working in his flower garden, he had to stop at times to catch his breath. He stated, “Even while I’m watching television, it is sometimes hard to breathe.”

On examination, the anteroposterior diameter of his chest was enlarged, and upon percussion, his chest exhibited a hyper resonant sound. A chest radiograph was taken, and pulmonary function tests were done. The chest radiograph revealed a flat, low diaphragm with lung hyperinflation, but clear fields. Pulmonary function tests showed decreased tidal volume and vital capacity, increased total lung capacity, and prolonged forced expiratory volume.

Which pulmonary disease is exhibited by Mr. S.’s symptoms? Justify your answer

Answer 1

Mr. S’s symptoms show that he is suffering from hyperinflation of lungs. Lungs get overinflate in this disease as the air gets trapped in the lungs. This condition can occur due to asthma or emphysema. Mr. S is suffering from emphysema due to shortness of breath.

Hyperinflated lungs become enlarged in size, pushes diaphragm to the lower ribs and makes it flat. All these symptoms are revealed in the X-ray of Mr. S, so he is confirmed for hyperinflation of lungs.