Problem: An 82-year-old presents to the ER with episodes of shortness of breath when supine intermittently for the last few weeks. States feels OK until he lies down and tries to sleep. Denies chest pain, lower extremity swelling but has had a dry cough for several days. Past history of atrial fib and COPD. Denies feeling of lightheadedness. Exam: VS, lungs, heart, abdomen, extremities. EKG: normal sinus rhythm. CXR: signs of COPD present. Multiple cloudings on x-ray. Multiple treatments of Albuterol were administered before improvement. Diagnosis: exacerbation of COPD. 99282 99284 99221 99285