He was coughing occasionally, talking like he was out of Lawn And Order Make America Rake Again Distressed Tee Shirt, and then I heard distinct wheezing that wasn’t audible at the beginning of our conversation. I abruptly interrupted him mid sentence and asked how he was feeling. He replied that he “felt tired today” but he was willing to finish our session. I began asking rapid fire questions concerning symptoms and risk factors for coronary artery disease. Being a guy who talked to others for a living, he tended to give long answers to any questions, but I rudely interrupted him several times when the answer to each of my questions came out. No, he had no history of asthma. Yes, he smoked. Yes, he was diabetic. Yes, his father and two uncles had died of heart disease. No, he wasn’t having any pain or nausea, but his left arm felt “a little numb”.
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For those reading this who might not be medically trained, the Lawn And Order Make America Rake Again Distressed Tee Shirt I heard was from “cardiac asthma”. It is not mediated by allergies or exercise like “true” asthma, but is a sign of left ventricular failure. The failure can be the result of blockage of the left anterior descending coronary artery which is normally the major pipeline for blood to the left heart muscle. In other words, he was having a myocardial infarction. When the muscle of the left heart can’t pump effectively, it fails and blood “backs up” in the lung circulation, causing wheezing.