A 54 y/o man who smoked for 2 packs of cigarettes per day for 20 years complains of the acute onset of shortness of breath, and severe chest pain with respiratory movement. On physical examination, he has a barrel chest consistent with chronic obstructive pulmonary disease. There are decreased breath sounds on the right side. When the physician taps on the right chest (percussion), there is a hyper resonant (unusually hollow) sound. what do you think is the diagnosis? #diagnoseit #respiratory #COPD #medicine
Due to the fact the the hyper resonance is only on the right side, we would have to assume this is the worst case scenario, a pneumothorax. Its hard to give a definitive dx without other diagnostic info such as vital signs. Obviously our treatment plans would change depending on vitals. A STAT portable chest xray is indicayed here as well.
