A 70-year-old woman was admitted for progressive effort dyspnea and palpitation of 5 years' duration and orthopnea
and paroxysmal dyspnea for 6 months.
He denied orthopnea
, edema, paroxysmal nocturnal dyspnea, and exertional chest pain.
The signs and symptoms of this type of heart failure are typically identical to other types of systolic failure (shortness of breath, orthopnea
, pulmonary edema, peripheral edema, fatigue).
Symptoms may include shortness of breath, persistent cough, dyspnea on exertion, orthopnea
, paroxysmal nocturnal dyspnea, chest pain, palpitations, dizziness, and abdominal discomfort (eg, hepatic congestion).
4,5,7] In all the cases, symptoms included dyspnea, fatigue, orthopnea
and chest pain.
Our patient was a 56 years old African American female, who presented to the emergency room with a two week history of progressive exertional dyspnea, paroxysmal nocturnal dyspnea, orthopnea
and bilateral lower extremity edema.
Physical examination showed orthopnea
, tachypnea, tachycardia, dullness and diminished breath sounds in both hemithoraxes.
7) Direct compression of the trachea and esophagus by goiters has long been known to also cause orthopnea
, obstructive dysphagia, and dyspnea.
This information demonstrates that the patient experiences orthopnea
While still in post-anesthetic care unit (PACU), she felt better and pulmonary auscultation showed basilar crackles and mild cyanosis (pulse oximetry showed a SPO2 of about 80-83%) with moderate dyspnea and orthopnea
after receiving furosemide, aminophylline and oxygen through facemask for two hours.
She denies orthopnea
or paroxysmal nocturnal dyspnea.
The patients presented with a wide variety of symptoms including embolic phenomenon (50%), shortness of breath, or orthopnea
(30%), though some were asymptomatic (10%).