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Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of human ehrlichiosis (caused by infection with Ehrlichia chaffeensis) is presented. The patient was a female Naval Academy midshipman with a 26-day history of daily field training with the U.S. Marines near Quantico, Virginia. She presented with a several-day history of myalgias, fever, and frontal headache. During her clinical course, she developed fever to 104 degrees F, dry cough, dyspnea on exertion, arthralgias, and nephrotic syndrome. She did not develop a rash. Laboratory studies were significant for thrombocytopenia, equivocal Lyme enzyme immunosorbent assay with a negative confirmatory western immunoblot, equivocal Rocky Mountain spotted fever acute serology without a convalescent increase in immunoglobulin G, and immunoglobulin G/immunoglobulin M serology positive for human monocytic ehrlichiosis. She manifested known sequelae for this emerging disease, including dyspnea, pedal edema, increased transminases, and nephrotic syndrome.
Mil Med 2001 Feb
PMID:A Naval Academy midshipman with ehrlichiosis after summer field exercises in Quantico, Virginia. 1127 20

Diagnosing the underlying etiology of dyspnea on exertion in adults can be challenging, often requiring the clinician to distinguish cardiac or pulmonary pathological conditions from metabolic, neurological, or hematological conditions or from chest wall abnormalities. We report such a case involving a 29-year-old, male, active duty Army soldier. With a history of a median sternotomy, symptoms of right- and left-side heart failure, and examination findings suggesting elevated right atrial pressure, pericardial disease was pursued. Echocardiography and cardiac catheterization revealed constrictive physiological features, namely, elevation and near-equalization of right- and left-side pressures and ventricular interdependence, whereas computed tomography illustrated pericardial thickening, ultimately leading to the diagnosis of constrictive pericarditis. The patient was treated with a complete pericardiectomy, leading to symptom resolution and improved exercise capacity. This case report of a rare condition offers a concise etiological and physiological overview of constrictive pericarditis and demonstrates an effective multimodal diagnostic approach. The scientific evidence provided may assist general practitioners in making decisions to differentiate this clinical condition from similar cardiac or cardiopulmonary conditions.
Mil Med 2007 Nov
PMID:Constrictive pericarditis: a cause of exertion-induced dyspnea in a soldier with a prior sternotomy. 1806 2

Partial anomalous pulmonary venous return (PAPVR) is an uncommon congenital abnormality that occurs in 0.4 to 0.7% of postmortem examinations. Ninety percent of these anomalies are associated with an atrial septal defect. Partial anomalous pulmonary venous return occurs more commonly on the right than the left and is manifested by abnormal return of the pulmonary veins to the central venous circulation. Most patients are asymptomatic, but when symptoms are present they are due to shunting of oxygenated blood to the venous circulation. We submit the case of a recently activated solider who presented with dyspnea on exertion refractory to inhaled corticosteroids and an 8.5-mm solitary pulmonary nodule. Further diagnostic imaging revealed PAPVR. Our case appears to be the first report of a solitary pulmonary nodule as the initial presentation of a right upper lobe PAPVR with return to the superior vena cava in the absence of associated atrial septal defect.
Mil Med 2008 Jun
PMID:Partial anomalous pulmonary venous return. 1859 12

Paradoxical vocal fold movement is important to consider in the differential for dyspnea on exertion or shortness of breath. It is often confused with asthma and remains undiagnosed because of a paucity of pathognomonic examination and imaging findings. This case serves as a reminder of the specific clinical picture, diagnosis, and treatment of paradoxical vocal fold movement. It also highlights the broader importance of continuity of care and the clinician's ability to revisit the differential diagnosis if an initial workup is unrevealing or the patient is not responding to treatment.
Mil Med 2015 Oct
PMID:What to Do When the Inhaler Fails: Revisiting the Diagnosis. 2644 82