Dyspnea 2

^{A 66 year old woman came to the clinic with history of shortness of breath since 1
week. The dyspnea is characterized by exacerbation during the night when she lies down in
bed and remission when she starts activities in the day time. There is no history of chest
pain, palpitations, dizziness or syncope. She also gives history of burning sensation
behind her chest immediately after food. Which of the following statements is true?}

^{Her condition is referred to as platypnea}
^{She is likely to have gastro esophageal reflux disease}
^{The only reason for her dyspnea is her body weight of 245 lb}
^{The treatment for her condition includes continuous positive airway pressure
ventilation.}

^{Answer: The answer is (b). The dyspnea described above is characteristic of orthopnea.
The most likely cause for her condition given that she has no other associated symptoms is
gastro esophageal reflux disease. She also has heartburns which can substantiate this
clinical suspicion. A coronary event should always be kept in mind and should be ruled out
with an ECG and Trop T assay. Continuous positive airway pressure is the treatment of
choice for obstructive sleep apnea which does not present in this manner.}