Patient history: A 37-year-old man presents with a complaint of cough that began approximately three months before this appointment. The cough is nonproductive and worse at night and after exercise. He has had a sedentary lifestyle but recently started an exercise program, including jogging, and says he is having a much harder time dealing with the exertion. He runs out of breath much earlier than he used to, and he coughs a great deal. He has not had any fever, blood-tinged sputum, or weight loss.
He denies nasal congestion and headaches and does not smoke. He has no significant medical history. Physical examination: His examination is notable for a blood pressure of 134/78 mm Hg, and lungs are clear to auscultation bilaterally, except for an occasional expiratory wheeze on forced expiration. A chest radiograph is normal. What is the most likely diagnosis for this patient, and how…
