Case Study - CN

A 73 year old Chinese lady (CN) presented with a 2 week history of breathlessness. She denies any chest pains. There was a significant past history of type 2 Diabetes Mellitus and coronary artery disease, having undergone a two vessel angioplasty in 2003, successfully. She had a fall 6 months ago witha stable fracture of her lumbar spine. She has lost her appetite. Her regular medications included Metformin 500mg BD, Ibesartan 150mg daily, cardiprin 100mg daily, pravastatin 20mg nocte. Physical examination was unremarkable with normal vital signs. Her lungs were clear.

Discussion :

1. What do you think is the cause of her breathlessness?
2. What test would you carry out to try and arrive at a diagnosis?
3. How would you manage this patient?