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JAMA Clinical Challenge
March 14, 2017

Increasing Hypoxemia and Dyspnea in Mild Chronic Obstructive Pulmonary Disease

Author Affiliations
  • 1Pulmonary, Critical Care and Sleep Medicine, Albany Medical College, Albany, New York
JAMA. 2017;317(10):1072-1073. doi:10.1001/jama.2016.20179

A man with a 3-year history of chronic obstructive pulmonary disease presented with increasing dyspnea on exertion, requiring increasing flow rates of oxygen. He was a former smoker with a 50–pack-year history. He had been diagnosed with stage I low-grade prostate cancer several years previously.

Lung examination showed no wheezing. Cardiac examination showed a prominent pulmonary component (P2) of the second heart sound. Noncontrast computed tomography of the chest was unremarkable.