Shortness of breath in a 62-year-old woman
Emergency DepartmentSarah Langer · 62yo female · CC: Shortness of breath
History
0/5 key findingsAsk the questions your differential demands — not just the ones the case volunteers. Every diagnosis you intend to list owes you one discriminating question.
CASE SETTING: EMERGENCY DEPARTMENT
Sarah Langer, a 62-year-old woman with 3 weeks of progressive dyspnea and a dull right hemithorax
Vitals
Opening
Sarah Langer, a 62-year-old retired bookkeeper, presents to the Emergency Department with 3 weeks of progressively worsening shortness of breath that now occurs when walking from her bedroom to the kitchen, accompanied by a dry cough and a heavy ache along her right lower chest. She is sitting upright on the stretcher breathing 22 times per minute with an oxygen saturation of 92% on room air.
Triage note
62-year-old female with 3 weeks of progressive exertional dyspnea and dry cough. SpO₂ 92% on room air, improved to 97% on 2 L nasal cannula. Afebrile.
From the patient
"Three weeks ago I just noticed I was winded carrying groceries up the steps, but this week I can barely walk to the kitchen without stopping to catch my breath, and my right lower chest feels heavy and full."
Sarah Langer · 62yo female
Sitting upright leaning slightly toward her right side, mildly tachypneic when speaking in full sentences