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Previous Volume 350:60-65 January 1, 2004 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.

A 51-year-old woman was admitted to a community hospital with a six-week history of progressive shortness of breath. She had initially noted dyspnea when climbing stairs at work, and by the time of admission it prevented her from walking more than 4.6 m (15 ft).

The rate of progression and the functional impairment imply a serious disorder. Progressive congestive heart failure could . . . [Full Text of this Article]

Commentary

Source Information

From the Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California at San Francisco School of Medicine, San Francisco (G.D.); the Department of Medicine, Legacy Good Samaritan and Emanuel Hospitals, Portland, Oreg. (K.E.S., D.J.G.); and the Ann Arbor Veterans Affairs Health Services Research and Development Center of Excellence, the Patient Safety Enhancement Program, Ann Arbor Veterans Affairs Medical Center and University of Michigan Health System, and the Department of Internal Medicine, University of Michigan Medical School — all in Ann Arbor (S.S.).

Address reprint requests to Dr. Dhaliwal at the San Francisco Veterans Affairs Medical Center, 4150 Clement St. (111), San Francisco, CA 94121, or at gurpreet.dhaliwal@med.va.gov.

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