An 80-Year-Old Man With Asbestos Exposure Presenting With Respiratory Distress

Our plain-English summary of An 80-Year-Old Man With Asbestos Exposure Presenting With Respiratory Distress, by A. Aron, A.E. Urban, J.A. Lanfranco, et al (Chest, 2017).

The study

• Authors: A. Aron, A.E. Urban, J.A. Lanfranco, A.X. Freire, I.H. Romero-Legro
• Journal: Chest
• Published: 2017;152(2):e25-e28
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This article is a case report, published in a question-and-answer teaching format, about an 80-year-old male veteran with a history of COPD and asbestos exposure. He came to the emergency department with worsening shortness of breath on exertion. The article does not say how, where or for how long he was exposed to asbestos, or which fiber type was involved. He was breathing rapidly, needed supplemental oxygen and was wheezing. The doctors performed a bedside ultrasound of the chest. A compression ultrasound of the legs was negative for deep vein thrombosis (DVT). The lung ultrasound showed what the authors call a "nude or normal profile", which they described as suggestive of a COPD or asthma flare-up in the right clinical setting. The ultrasound also showed asbestos-related pleural plaques, seen as a well-defined, smooth anechoic (echo-free) space. The article does not report the patient's treatment or outcome. The authors concluded that bedside ultrasound of the pleura can correctly identify pleural plaques and can help avoid CT scanning for such a benign condition.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single patient, "Ultrasound Corner" question-and-answer teaching format)
• Who was studied: One 80-year-old male veteran with a history of COPD, peripheral vascular disease, DVT, abdominal aortic aneurysm, gastroesophageal reflux disease and asbestos exposure. The authors are from the University of Tennessee HSC, Memphis, TN. No date is given.
• Exposure: A history of asbestos exposure, stated without any details of fiber type, job, product or amount
• Main results:
  • On arrival the patient was breathing rapidly, needed supplemental oxygen and was wheezing. The rest of his examination and an ECG were unremarkable.
  • A compression ultrasound was negative for DVT.
  • The patient's lung ultrasound showed a 'nude or normal profile', which the authors described as suggestive of COPD or asthma exacerbation in the correct clinical scenario.
  • The patient's ultrasound showed asbestos-related pleural plaques, appearing as a well-defined, smooth anechoic space.
  • The patient's ultrasound also showed lung sliding, no lung point, and no B-lines on either side.
• The authors' conclusion: The authors concluded that point-of-care ultrasound of the pleura can correctly identify pleural plaques and will help avoid CT imaging for such a benign condition. They also said it can distinguish plaques from pleural-based masses, and that they aimed to promote awareness among pulmonologists of asking about asbestos exposure.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure.

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