Go with the Flow: An Elderly Man with a Pleural Effusion

摘要

An 87-year-old man with chronic obstructive pulmonary disease was referred to our clinic after a chest computed tomography scan revealed a new, moderate-sized pleural effusion (Figure 1). His history revealed a pulmonary embolism, but he had not received anticoagulation for 11 years. A deep vein thrombosis was diagnosed in the patient 6 weeks before this visit, and he resumed coumadin. The patient had begun to notice a significant decline in his exertional tolerance over the previous few months. He denied chest discomfort, orthopnea, lower extremity edema, fever, or chills. He had undergone an intentional 10-pound weight loss, which he attributed to a change in diet.