A year-old man with a pack-year history of cigarette smoking presents with worsening exertional dyspnea. Two-dimensional echocardiography revealed a mean pulmonary artery pressure PAP of 53 mm Hg with normal right ventricular size and function. Right heart catheterization at the time of diagnosis confirmed the elevated mean PAP with a capillary wedge pressure of 12 mm Hg and peripheral vascular resistance of 7 wood units. The study was positive for vasodilator response with a drop in mean PAP to 40 mm Hg. Cardiac output remained stable. The patient was started on long-acting nifedipine.
Case Management of COPD Patients from Acute to Post-Acute Care Settings
Case Study. John, a year-old Caucasian man, comes to the emergency department with worsening dyspnea, fever, cough, and increased purulent sputum production. He has no other medical conditions, and no known allergies.
Mr Jones is a year-old male who has had 11 emergency department visits and five hospital admissions in the last 12 months, all of which are attributed to chronic obstructive pulmonary disease COPD exacerbations. At each visit to the emergency department, Mr Jones received standard pharmacological treatment and was discharged to home with no additional services. The length of stay for each hospital admission was 1 day. This patient scenario occurs frequently at hospitals across the United States.