Rebounding From Breathlessness: A Case Of Wheezing And Dyspnea In A Collegiate Women's Basketball Player

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Rebounding From Breathlessness: A Case Of Wheezing And Dyspnea In A Collegiate Women's Basketball Player - Page #1

Author: Clarinda Hougen, MD Senior Editor: Heather Rainey, MD Editor: Jonathan Santana, DO Patient Presentation: A 22-year-old collegiate womens basketball player with no significant medical history presented to her team physician with a complaint of chronic dyspnea on exertion. History: The patients dyspnea had started several years prior, limiting her ability to play basketball at full capacity. This was felt by her previous provider to be attributable to vocal cord dysfunction or possible gastroesophageal reflux. She was referred to speech therapy, which did not resolve her symptoms. She continued treatment of dyspnea and wheezing with budesonide but did not have any improvement. The patient denied any dyspnea or wheezing at rest. There was no sensation of dysphagia. She denied any chest trauma. About one year later, she presented to a pulmonologist for further evaluation. Physical Exam: General: Conversant, no active distress. Head, Eyes, Ears, Nose, and Throat (HEENT): Normocephalic and atraumatic; eyelids and conjunctivae appear normal; extraocular movements are intact; pupils are equal, round, and reactive to light. Oropharynx is normal. Neck: Neck was supple with no lymphadenopathy and no thyroid masses. Cardiovascular: Regular rate and rhythm; normal first and second heart sounds; no murmurs detected. Pulmonary: Breathing comfortably on room air; lungs are clear to auscultation bilaterally. Abdomen: Abdomen was soft, nontender, and nondistended; no gross enlargement of abdominal organs. Extremities: No edema, clubbing, or cyanosis noted. Skin: No rashes observed. Neurological: Alert and oriented to person, place, and time; cranial nerves II through XII are grossly intact; speech is normal. Psychiatric: Mood and affect appear normal. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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