Your patient is an 82-year-old woman whose daughter called EMS because the patient became very short of breath as they walked from their parking spot to the front of their church. On your arrival, the patient states that she just needed a little rest and now feels much better. On questioning, she admits to several such episodes in the past month. She denies chest pain and she says, "I just got winded because I'm getting so old." The patient has a heart rate of 104, a respiratory rate of 20, and blood pressure of 172/90 mmHg. Your history and physical examination should focus on which of the following possibilities?

Question

Quizplus · Accepted Answer

DThe patient's symptoms of becoming very short of breath during exertion, along with her denial of chest pain but admission of several similar episodes in the past month, suggest a cardiac issue like myocardial infarction (A) and a respiratory condition such as COPD (D). The absence of specific symptoms for thyroid storm (B) such as fever, palpitations, or tremors, and for cerebrovascular accident (C) like unilateral weakness or speech difficulties, makes these less likely. The elevated heart rate and blood pressure could be responses to an underlying cardiac issue, and the episodic nature of her symptoms along with her age makes COPD a consideration.

Your Patient Is an 82-Year-Old Woman Whose Daughter Called EMS