A 58-Year-Old Man With Position-Dependent Nocturnal Dyspnea

Slides:

Advertisements

Similar presentations

Debapriya Datta, MD, FCCP, Vanessa Yap, MD CHEST

Advertisements

A Man in His 60s With Circulatory Collapse

Volume 93, Issue 6, Pages (June 1988)

Epidemiology and Treatment of Lung Cancer in Seattle

Volume 137, Issue 6, Pages (June 2010)

Volume 101, Issue 2, Pages (February 1992)

Hyperbaric Oxygenation in Cardiac and Pulmonary Disease

Volume 151, Issue 4, Pages (April 2017)

Volume 139, Issue 2, Pages (February 2011)

Volume 138, Issue 5, Pages (November 2010)

Single-Breath Washout Tests to Assess Small Airway Disease in COPD

Apical Localization of Pulmonary Tuberculosis, Chronic Pulmonary Histoplasmosis, and Progressive Massive Fibrosis of the Lung Robert A Goodwin, M.D.,

Frank W. Ewald, MD, FCCP, Albert H. Scherff, MD CHEST

A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer Ajay Dhakal, MBBS, Hongbin Chen, MD, PhD,

The Curious Case of a 55-Year-Old Man With New-Onset Seizures

COUNTERPOINT: Is the Apnea-Hypopnea Index the Best Way to Quantify the Severity of Sleep-Disordered Breathing? No Naresh M. Punjabi, MD, PhD, FCCP CHEST

A Man in His 60s With Circulatory Collapse

Wake-Up Right-Sided Hemiparesis and Dysarthria in a Heavy Snorer

Volume 153, Issue 1, Pages (January 2018)

Mohamed Ramez Mourad, MD, Olivia M. Siwoski, MD, Kyle R. Brownback, MD

Volume 153, Issue 2, Pages e33-e36 (February 2018)

A 15-Year-Old Boy with Mysterious Variability in Apnea-Hypopnea Index

A Newborn Infant With Oxygen Desaturation During Sleep

Volume 153, Issue 1, Pages (January 2018)

Volume 149, Issue 5, Pages e141-e145 (May 2016)

A 61-Year-Old Caribbean Man With Thrush and Acute Respiratory Failure

A 26-Year-Old Man With a Pleural Effusion and Headache

Peter Hountras, MD, Hector Cajigas, MD CHEST

Severe Central Sleep Apnea Associated With Chronic Baclofen Therapy

A 77-Year-Old Woman With Acute Shortness of Breath and Chest Pain

Debapriya Datta, MD, FCCP, Vanessa Yap, MD CHEST

An Elderly Man With Dyspnea and Chest Pain

Jessica Cooksey, MD, Babak Mokhlesi, MD, FCCP CHEST

Sleep Apnea, Hypothyroidism and Pulmonary Edema

A 43-Year-Old Man With Daytime Sleepiness and a Heart Murmur

Chok Limsuwat, MD, Philip J. Daroca, MD, Joseph A. Lasky, MD CHEST

Volume 151, Issue 5, Pages (May 2017)

A 67-Year-Old Man With Palpitations During Sleep

Imaging for the Management of Community-Acquired Pneumonia

A 48-Year-Old Athletic Man With Bradycardia During Sleep

Volume 149, Issue 1, Pages e29-e33 (January 2016)

A Patient With Chest Pain and Hyperacute T Waves

Volume 150, Issue 6, Pages e167-e170 (December 2016)

Volume 152, Issue 2, Pages e25-e28 (August 2017)

Bedside Calibration Of Pulmonary Artery Catheters

A 7-Year-Old Boy With Sudden Onset of Loud Snoring

An 80-Year-Old Man With Hemoptysis and Unilateral Patchy Opacities

A Man in His 70s Presenting With Chest Pain and Hematuria

Volume 154, Issue 6, Pages e169-e171 (December 2018)

Nasal Airflow in Sleep-Disordered Breathing

Volume 155, Issue 3, Pages e69-e74 (March 2019)

Volume 42, Issue 2, Pages (August 1962)

Sean Connolly, MD, Peter Hountras, MD CHEST

Chronic Cough in a 70-Year-Old Woman

Volume 154, Issue 3, Pages e83-e86 (September 2018)

David Bédard Méthot, MD, Évelyne Leblanc, MD, Yves Lacasse, MD CHEST

Luke A. Seaburg, MD, Hiroshi Sekiguchi, MD CHEST

Volume 149, Issue 5, Pages e151-e155 (May 2016)

Volume 156, Issue 1, Pages e9-e13 (July 2019)

A 15-Year-Old Girl With Sleep-Onset Insomnia and Poor Sleep Quality

A Man in His 60s With Circulatory Collapse

Bilal A. Jalil, MD, J. Shaun Smith, DO, Karim El-Kersh, MD CHEST

John Reid, MD, Donald Cockcroft, MD CHEST

A Woman Admitted to the ED With Severe Acute Respiratory Failure

A Newborn Infant With Oxygen Desaturation During Sleep

Volume 156, Issue 2, Pages e41-e45 (August 2019)

Mohamed Ramez Mourad, MD, Olivia M. Siwoski, MD, Kyle R. Brownback, MD

A 58-Year-Old Woman With Pneumonia and Gram-Negative Diplococci

A 23-Year-Old Man With Dyspnea During Myasthenia Crisis

A 21-Year-Old Man With “Sloshing” in the Chest

Presentation transcript:

A 58-Year-Old Man With Position-Dependent Nocturnal Dyspnea Anke Schertel, MD, Christian M. Horvath, MD, Jacqueline Pichler Hefti, MD, John-David Aubert, MD, Anne-Kathrin Brill, MD CHEST Volume 152, Issue 2, Pages e51-e55 (August 2017) DOI: 10.1016/j.chest.2017.03.014 Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 1 CT scan of the chest. Lung with idiopathic pulmonary fibrosis on the patient’s left, transplanted lung on the right. CHEST 2017 152, e51-e55DOI: (10.1016/j.chest.2017.03.014) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 2 Ventilation-perfusion scan in the supine position, showing a distribution of ventilation and perfusion in favor of the transplanted lung: perfusion (left/right), 5%/95%; ventilation (left/right), 12%/88%. CHEST 2017 152, e51-e55DOI: (10.1016/j.chest.2017.03.014) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 3 Polysomnography overview, visualizing the pronounced desaturation (yellow background) in the right lateral position (red line in the position graph). MT = movement time; R = stage REM; S1-S4, stages 1-4; SpO2 (Spo2) = oxygen saturation as measured by pulse oximetry; TCCO2 (Ptcco2) = transcutaneous carbon dioxide pressure; W = wakefulness. CHEST 2017 152, e51-e55DOI: (10.1016/j.chest.2017.03.014) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 4 A 5-minute window of the polysomnography recording. A, Left lateral position: central sleep apnea/Cheyne-Stokes respiration causing moderate oxygen desaturations. B, Right lateral position: central sleep apnea/Cheyne-Stokes respiration with central apneas followed by a greater degree of desaturation. Cycle length: left lateral position, 47.5 s; right lateral position, 34.7 s. EOG-L, EOG-R, = electro-oculography (electrodes at left and right eye, respectively); Flow_DR = nasal respiratory flow. See Figure 3 legend for expansion of other abbreviations. CHEST 2017 152, e51-e55DOI: (10.1016/j.chest.2017.03.014) Copyright © 2017 American College of Chest Physicians Terms and Conditions