BMJ  2004;328:698 (20 March), doi:10.1136/bmj.328.7441.698

Clinical review

Interactive case report

A 66 year old woman with breathlessness: case presentation

¹ Royal Victoria Hospital, Dundee DD2 1SP, ² Ageing and Health, Division of Medicine and Therapeutics, Ninewells Hospital, University of Dundee, Dundee DD1 9SY

The first 150 words of the full text of this article appear below.

Mrs Dempsey is a 66 year old woman who until recently had led a fit and active life. She was referred to the acute medical assessment clinic with a two month history of breathlessness and swollen ankles. She complained, "I get out of breath when I do the housework and I can't even walk to the corner shop." Her general practitioner had thought she had heart failure and prescribed diuretics. Further questioning revealed the onset to be insidious and that her dyspnoea had not improved despite diuretics. She described four pillow orthopnoea and denied chest pain, palpitations, wheeze, or cough.

On examination she was hypertensive (blood pressure 181/91 mm Hg) and her heart rate was regular at 98 beats a minute. Her jugular venous pressure was raised, she had a pansystolic murmur, and no added heart sounds. She had mild ankle oedema. Her oxygen saturation was 93% and stony dullness . . . [Full text of this article]

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