Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive exertional dyspnea, non-productive cough, and occasional pleuritic chest pain. History significant for smoking or underlying emphysema. Symptoms exacerbated by physical activity. Denies hemoptysis, fever, or night sweats.
Clinical Examination Findings
General: Patient in no acute distress, resting comfortably. Respiratory: Decreased breath sounds noted on auscultation, particularly in upper lung fields. Hyper-resonance to percussion. Chest wall expansion symmetric but reduced. No accessory muscle use at rest.
Treatment Protocol
Management plan: Smoking cessation counseling, pulmonary rehabilitation, and bronchodilator therapy. Surgical consultation for bullectomy if bullae occupy >30% of hemithorax or cause significant compression of adjacent lung parenchyma. Monitor for pneumothorax.