Question

What is the significance of Hyperresonance in a patient with a barrel shaped chest?

CASE STUDY

Joe Ritter, a 74-year-old retired bricklayer, has a 40-pack-year tobacco history and a history of chronic obstructive pulmonary disease (COPD). Today, he presents to the emergency department in respiratory distress with shortness of breath, retracting respirations of 26 breaths/min, BP is 154/76 mm Hg, pulse is 140 beats/min, rapid and irregular and temperature is 37°C.  He also complains of chest discomfort and left leg pain (8 on 0-to-10 scale). His skin color is pale gray, his chest is barrel-shaped, and he uses accessory muscles to breathe; he appears anxious and is sitting in a tripod position. His nail beds are bluish in color; his oxygen saturation by pulse oximetry is 86%.  Chest auscultation reveals wheezes and decreased-to-absent breath sounds in bilateral bases. Hyperresonance is noted upon chest wall percussion. Chest x-ray showed atelectasis bilaterally in the bases. Mr. Ritter coughs with minimal amounts of clear sputum.  A 12-lead ECG recorded his heart rate as 140 beats/min, rapid, and irregular with an interpretation by the physician as atrial fibrillation.  Upon further exam the left lower extremity is edematous warm and tender to touch.

Answer 1

Answer: In the case of barrel chest, the chest is bulged as well as looks like a barrel shape. The hyperresonance signify the presence of pulmonary disease to the extent stage. The resonance of the chest can be easily heard in the patient having pulmonary disease with the barrel chest. Barrel chest may signify that there is presence of pulmonary disease. And in this case, it is due to presence of the disease COPD.