Reference no: EM133707176

Question

Chief complaint: Gerald Romero, a 67 year old male, has been admitted to the hospital for treatment of shortness of breath. He has a three month history of increasing shortness of breath and decreased exercise tolerance. His wife accompanies him, and mentions that she is concerned as he seems to have more tremor in his hands than he used to, and he occasionally stumbles. History: Three months ago Gerald began to experience dyspnea while climbing stairs. The shortness of breath has gradually worsened, and it now occurs after he walks over ten feet. He has a chronic cough that produces one to two tablespoons of yellowish sputum daily. The cough and sputum production have not recently changed. He denies hemoptysis and wheezing. He quit smoking three months ago because of his increasing dyspnea. Prior to that time, he smoked one pack of cigarettes a day for 50 years. He denies alcohol use. Review of Systems: Neuro: reports mild dizziness "when I get real short of breath"; denies seizures, headaches. Has some difficulty sleeping because of the shortness of breath as he cannot lie flat; "my wife says my hands shake more now." States "feeling really old these days", c/o chronic.