A 65-year-old male presented to the OPD with progressive dyspnea on exeion for 3 months. Patient records told that he had an episode of necrotizing pancreatitis along with ARDS in the past for which he was mechanically ventilated for a long time. Patient is a chronic smoker. On examination, low pitched inspiratory and expiratory wheeze is heard over mid-chest area. PFTs revealed, FEV1 is 78% of predicted. FEV1/FVC ratio is 60%. Flow volume curve is given. What is the most likely diagnosis in the above case: -
Subacute dyspnea, stridor and airway obstruction - consistent with diagnosis of subglottic stenosis - related to his prior prolonged mechanical ventilation. Flow volume curve loop is suggestive of fixed airflow obstruction.
COPD
Subglottic stenosis
Idiopathic pulmonary fibrosis
Unilateral vocal cord paralysis
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