History of Present Illness (HPI)
A 38 year old obese Caucasian male with a history of asthma presents to the emergency room because he felt that a piece of chicken from his dinner 6 hours prior was stuck in his throat. He is able to converse but is unable to tolerate liquids and spits up saliva every few minutes. He describes intermittent dysphagia to solids, not liquids, for the past ten years but had previously not sought evaluation. He reports intermittent heartburn x 10 years for which he takes over the counter antacids as needed. He denies odynophagia, unintentional weight loss, chest pain, nausea, vomiting, melena, hematochezia, or rashes. His medications include OTC antacids and an albuterol inhaler. He has a 20 pack year smoking history. No history of radiation to the neck or chest. No family history of esophageal cancer.
Click Here for the Physical Exam!
Case 8 Index: