Case 37

John Stradling, Andrew Stanton, Najib Rahman, Annabel Nickol and Helen Davies

in Oxford Case Histories in Respiratory Medicine

Published on behalf of Oxford University Press

Published in print July 2010 | ISBN: 9780199556373
Published online November 2012 | e-ISBN: 9780191753299 | DOI:

Series: Oxford Case Histories

Case 37

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A 45-year-old man with a 5-year history of COPD had become increasingly symptomatic in recent months, with frequent exacerbations and several admissions, receiving non-invasive ventilation on one occasion. Dyspnoea during activities (such as getting dressed) and poor exercise tolerance limited him to walking around the house only (6-min walk distance markedly reduced at 140m). He was an ex-smoker with a 40 pack-year history, and had suffered with asthma since childhood. He had a right-sided pneumothorax a year previously, which failed to resolve with chest drain insertion and attempted talc pleurodesis. A Heimlich flutter valve was therefore substituted for the underwater seal in order to allow him to go home until the pneumothorax resolved some months later.

Chapter.  2109 words.  Illustrated.

Subjects: Respiratory Medicine and Pulmonology

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