QUIZ_CASE_OF_THE_MON.. - The Lung Center

QUIZ CASE OF THE MONTHA 27-year-old man presents with progressive dyspnea following aninitial scuba-diving training session. Approximately 1 hour into the dive, hebegan to feel mild chest tightness directly under his breastbone; thisprogressed to difficulty breathing with a frequent, nonproductive coughover the following 8 hours. The patient had accidentally held his breath ashe ascended from a depth of approximately 12 ft to a depth of 10 ft in aswimming pool.On physical examination, the patient is an anxious-appearing,healthy young man with mildly labored breathing. He has a pulse rate of 71bpm, a blood pressure of 129/85 mm Hg, a respiratory rate of 16breaths/min, and an oxygen saturation of 98% while breathing room air.Auscultation of the lungs reveals clear breath sounds. There is no dullnessto percussion throughout the lung fields. His speech is normal; his neck iswithout fullness, jugular venous distention, tracheal deviation, orsubcutaneous emphysema. There is no pedal or extremity edema present.The heart sounds are normal. The neurologic examination reveals nodeficits. The remainder of the physical examination yields noabnormalities.A chest radiograph is unrevealing. Computed tomography(CT) scans of his chest is shown below.

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