{"ops":[{"insert":"A 60 year old caucasian man presents with dyspnea at rest for 1 month.\n\nClose questioning reveals a history of exertional dyspnea for 2 years (which he attributed to \u0027aging\u0027), and ankle swelling for the last 3 months.\n\nHe has smoked for a total of 62 pack years, and has not been medically evaluated for many years.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-191_en.png"}},{"insert":"\n"}]}
2
Investigate
Chest X-Ray
{"ops":[{"insert":"The lung fields are hyperinflated. A prominent pulmonary conus is noted.\n"}]}
CT Chest
{"ops":[{"insert":"The CT scan shows emphysematous changes in both lungs. There is marked dilation of the right main pulmonary artery, pulmonary arterial trunk, and right ventricle.\n"}]}
