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ab case II 

CC: Sensation of suffocation, wheezes and chest discomfort accompanied by cold sweating and palpitations. Hiistory of Present Illness: 

This is a 45 y/o male with past history of bronchial asthma, arterial hypertension and an ischemic event of the heart. He who was doing “well” until approximately a week when was suddenly awaken by a sensation of suffocation accompanied by cold sweats, palpitations and wheezes. The cold sweats and suffocation resolved after standing in front of a window and breathing for a few minutes. The palpitations continued for over 20 minutes. The wheezes resolved with pharmaco-therapy from aerosol pump resolving a few minutes afterwards.

History of Past Illness: 

He is asthmatic since 12 years of age and experiences frequent exacerbation of broncho-constrictive symptoms that resolves with pharmaco-herapy. He was diagnosed with arterial hypertension 10 years ago . Currently is “controlled ” with oral pharmacotherapy. Regarding palpitations, these occur suddenly and are commonly accompanied with cold sweats. 

History of Past Illness: Three years ago while playing basketball with some friends he developed a sudden burning sensation on the chest accompanied by palpitations, dizziness and cold sweats. He was taken to the emergency room where after extensive evaluation a small ischemic region of the heart was identified. After 5 days at the hospital he was discharged home and told to continue with his antihypertensive pharmaco-therapy.

Review of systems: 

Neurological: 

There is no history of neurological deficits neither neuropsychiatric disorders

Respiratory: 

there is history of intermittent exacerbations of bronchial asthma that resolve with aerosol pharmacotherapy. Cardiovascular: 

History of ischemic episode and arterial hypertension under oral pharmacotherapy 

Gastrointestinal:

 No histoty of change in bowel habits nor intolerance or allergies to food. 

Social history:

 He has worked for a hardware store in the credit department all his life. His position require to make difficult decisions accompanied by stressful episodes. He denies the use of tobacco or ilegal drugs. His alcohol consumption is limited to a wine cup every night before his meal. 

Family history: 

There is no history of mayor illness, toxic habits nor neuropsychiatric disorders.
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