“How are you feeling, Ms. Jones?”
“Have you been more short of breath lately?”
“Not really, just when I exercise.”
“How much exercise?”
“I dunno. But after I go to the mailbox and walk back up to the house, I’ve got to stop now where before I didn’t.”
Exertional dyspnea. It conjures up a large differential of potential cardiovascular or pulmonary causes. And as the above commonly-encountered doctor-patient conversation demonstrates, the problem is a dynamic one: at rest things are often fine, on exertion or with recumbency less so.
Now imagine that the doctor then sees elevated neck veins, hears rales in the lower lung fields, and sees swollen ankles on their patient. Heart failure, right? Read more »
*This blog post was originally published at Dr. Wes*