What Is The Most Appropriate Time To Obtain Peak Flow Readings With The Best Peak Flow Number?

A. Immediately following a meal or at night before bedtime

B. Three times per week: morning, lunch and dinner

C. Once weekly: after breakfast and again before going to sleep

Case 14-1

History of Present Illness

The patient is a 42-year-old man who presents to the emergency department with chest pain that radiates down his left arm and interferes with his ability to take deep breaths as well as feel comfortable lying on his back for extended periods of time without experiencing discomfort. His medical history is significant for hypertension, type 2 diabetes mellitus, coronary artery disease, hypercholesterolemia, obesity, smoking history (25 pack years), alcohol abuse (2 drinks/day) and depression. The patient reports prior episodes of chest pain during which he has been treated medically only but the events have escalated over time from mild intermittent claudication to severe acute refractory angina pectoris followed by cardiac arrest necessitating defibrillation twice in the past year due to dysrhythmias associated with ventricular fibrillation that required rapid cardioversion using an AED device designed specifically for this purpose. He denies any other cardiovascular complaints including syncope or palpitations nor does he report heartburn or nausea related to upper GI bleeding from esophageal varices noted 2 months ago which led him initially into urgent care where a nonbleedable ulcer was diagnosed even though there were no other