An 80-year-old man presented to the emergency department with exertional dyspnea. His symptoms had begun 3 weeks prior to presentation and had progressively worsened. Additional review of systems elicited nonexertional chest pain, orthopnea, hemoptysis, and epistaxis. He reported no fever, chills, headaches, night sweats, weight changes, sputum production, abdominal pain, nausea, vomiting, or obstructive voiding symptoms. He lived in southeastern Minnesota and had no recent travel history. Forty years previously, he had discontinued his habits of smoking, drinking alcohol, and consuming illegal drugs. He was a veteran of the US Navy and had worked as a welder. His family history was notable for a brain tumor in his mother. His medical history included hypertension, hyperlipidemia, peripheral vascular disease, stage 3B chronic kidney disease, nonischemic cardiomyopathy, and vitamin B12 deficiency. We were unable to obtain a reliable record regarding his weight. He had not completed age-appropriate cancer screening. His current medications were metoprolol tartrate (25 mg taken twice daily) plus daily aspirin (81 mg), furosemide (20 mg), and pravastatin (40 mg).

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CORRECT ANSWERS: 1. c. 2. b. 3, e. 4. d. 5. a.

Article InfoPublication History

Published online: July 03, 2021

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Potential Competing Interests: Dr Warczytowa owns stock in Amarin Corporation, Exact Sciences Corporation, and Zimmer Biomet. The other authors report no competing interests.

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DOI: https://doi.org/10.1016/j.mayocp.2020.12.040

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© 2021 Mayo Foundation for Medical Education and Research

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