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.A 65-year-old man had shortness of breath with exertion and swelling in feet over the past 8 months. for 2 days he had ..dyspnea.. even at rest, his sputum was yellowish. He was treated with ..digoxin.., diuretics, ..angiotensin.. converting enzyme inhibitor and antibiotics. His cough improved but remained very short of breath and became so weak and lightheaded that he went to the emergency room..
.On examination, his BP was 86/58 mmHg, HR 112bpm, respiration 25/minute. There was no jugular venous distention and no edema. Lung exam revealed diffuse end-..inspiratory.. crackles and occasional wheezes. Chest radiograph showed hyper-inflated lung without pulmonary congestion. Arterial blood gas revealed PH 7.32, PCO..2.. 47, PO..2.. 55mmHg. The pulmonary artery pressure was estimated to be 30 mmHg..
.1.What kind of hypoxia had the patient? What are their causes and evidences?.
.2.Why did the patient have shortness of breath and become weak and lightheaded? their mechanisms?.
.3.What are the mechanisms of hypotension, pulmonary hypertension, increase of heart rate and respiratory rate?.
.4. Should the therapy be changed? why and how to change it?.
