The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 42-year-old man with no significant past medical history presents to the emergency department (ED) with a long-standing history of dyspnea that has been persistently worsening for the past 2 years. The dyspnea is worse upon exertion and is associated with decreased exercise tolerance. No associated chest pains, palpitations, dizziness, or syncope are noted. The patient denies any associated cough, hemoptysis, fever, or weight loss.
Upon initial presentation to his primary care physician (PCP) at the time of symptom onset, a cardiac stress test and pulmonary function testing were within normal limits; however, his symptoms have persisted. He has been prescribed zolpidem, as needed, by his PCP, who labeled his condition anxiety-related. The shortness of breath has progressively gotten worse. The patient can no longer exercise, or even walk, without becoming short of breath. The patient is an active tennis player and has no family history of heart disease. He does not take any medications or herbal supplements, and he has no known drug or food allergies. The patient has no history of smoking, alcohol abuse, or illicit drug use.
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Cite this: Kennedy O. Omonuwa. A 42-Year-Old Tennis Player With Dyspnea Blamed on Anxiety - Medscape - Apr 08, 2022.