Chest
Volume 100, Issue 4, October 1991, Pages 1151-1154
Journal home page for Chest

Pulmonary Physiologic Test of the Month
Physiologic Evaluation of Bullous Emphysema

https://doi.org/10.1378/chest.100.4.1151Get rights and content

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CASE HISTORY

A 61-year-old male smoker was referred for the evaluation of progressive dyspnea on exertion. The patient had noted slight dyspnea on exertion for several years. For his occasional exacerbations of chronic obstructive lung disease, he was treated with inhaled ß-agonists and bursts of steroids. Five months prior to evaluation, he began noticing progressive exertional dyspnea mowing his grass or even climbing a single flight of stairs. He denied fever, chills, weight loss, night sweats,

Postoperative Exercise Physiology

Multistaged maximum exercise (Table 2) was again carried out. The patient now achieves 70 percent of predicted maximum workload and 74 percent of V˙O2 maximum; a 20 percent increment in workload. MVV increased by 30 L to 120 L/min. Comparing the two exercise tests at workloads of 90 W, minute ventilation remained excessive (63 L/min); however, the breathing frequency response was significantly less (34/min) and tidal volumes increased by approximately 400 ml to 1,840 ml. Physiologic

DISCUSSION

Progressive dyspnea on exertion is a common complaint of patients presenting to internists and pulmonologists. While a careful history and physical examination with chest roentgenogram often reveals the underlying abnormality, full pulmonary function and exercise testing gives additional, useful information that may be used in planning and documenting efficacy of therapy. We present a case of progressive dyspnea on exertion secondary to bullous emphysema with the results of pulmonary physiology

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From the Pulmonary Physiology Unit, Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, and Pulmonary Sciences Division, University of Colorado, Health Sciences Center, Denver.

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